PROFAV-ENGLISH-COVER.

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Promotion of Fruit
and Vegetables
for Health
Report of the Pacific Regional Workshop

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ISBN 978-92-5-108879-1

9 7 8 9 2 5 1 0 8 8 7 9 1
I4935E/1/09.15
Cover photographs:
Pomegranate – © Augustus Binu; Colocasia esculenta Taro – © David Monniaux; Rambutans Challiyil – © EswaramangalathVipin;
Cashew apples – © Abhishek Jacob
 Promotion of Fruit
and Vegetables for
Health

Report of the Pacific Regional Workshop

FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS

Rome, 2015
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ISBN 978-92-5-108879-1

© FAO, 2015

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Table of contents

Acronyms v

Executive Summary vii

1 Introduction 1

2 Background 3

3 Meeting Report, conclusions and recommendations 5

4 Presentations 11

5 Kobe framework for promoting fruit and vegetables at national level 23

Annex 1 Workshop conclusions/ Group discussions 47

Annex 2 Participants 57
Annex 3 Workshop agenda 59
Annex 4 Questionnaire instructions 61
Annex 5 Questionnaire 65

References 81

iii
Acronyms

ACIAR Australian Center for International Agricultural Research

AusAid Australian Agency for International Development
FAO Food and Agriculture Organization of the United Nations
FCT Food Composition Table
F&V fruit and vegetables
GAP good agricultural practices
ICTs information and communication technologies
IPM integrated pest management
ISHS International Society for Horticultural Science
NCD non-communicable disease
OSP Orange Sweet Potato
PARDI Pacific Agribusiness Research for Development Initiative
PICTs Pacific Island Countries and Territories
PROFAV Promotion of Fruit and Vegetables for Health Initiative
SPC Secretariat of the Pacific Community
STEPS WHO STEP wise approach to Surveillance
UN United Nations
WHA57.17 Fifty-seventh World Health Assembly
WHO World Health Organization

v
Executive Summary

The Food and Agriculture Organization (FAO) and World Health Organization (WHO)
of the United Nations (UN) have been leading the global initiative “Promotion of Fruit
and Vegetables for Health” (PROFAV) to raise awareness and to boost fruit and vegetable
production, supply and consumption to improve people’s health – and farmers’ incomes. The
regular consumption of a variety of fruit and vegetables is essential for a well-balanced diet
and for avoiding non-communicable diseases (NCDs). Low intake of fruit and vegetable is
largely attributed to unhealthy diets in developed countries, and to poverty and food insecurity
in developing countries.
FAO organized a workshop to focus on South Pacific island communities. In the Pacific Island
Countries and Territories (PICTs), fruit and vegetable intake is well below the recommended
level of five servings per person per day, or 400 g per day. This largely contributes to the high
prevalence of NCDs. Furthermore, over half the population in all of the PICTs are overweight.
Alongside obesity, under-nutrition and micro-nutrient deficiency.
During the workshop, it emerged that national institutions in most countries of the region
have established strategies for NCD prevention and have been implementing programmes
to advocate for healthy diets and lifestyles through the increased consumption of fruit and
vegetables. Nonetheless, efforts should be strengthened and greater integration of activities
among horticulture, nutrition, health and education stakeholders is considered essential.
The island countries of the Pacific generally face challenges in securing year-round adequate
supply of fresh fruit and vegetables. It was recognized that NGOs, civil society and especially
faith-based organisations can play a key role among stakeholders in increasing awareness and
facilitating programmes to improve availability and consumption of fruit and vegetables for
health. It is important to join efforts and support the PROFAV initiative and become active
stakeholders.
After the workshop, the participants will continue to provide more information through a
survey prepared by FAO. It is recommended to encourage new development partners to join
and support countries in the implementation of the PROFAV agenda and foster information
sharing. One of the recommendations was to establish a PROFAV networking mechanism
that will enhance the interaction across horticulture, health and education sectors within
countries and among the Pacific island countries by making information available on websites
and e-newsletters. This will provide a good baseline to characterize production, supply and
consumption of fruit and vegetables and will allow identifying needs and areas for future
intervention in the region.

vii
 Pomegranate DSW
© AUGUSTUS BINU

viii
1 Introduction

There is growing awareness of the fundamental and vital role fruit and vegetable consumption
plays in human health and nutrition in both developing and developed countries. This increased
global awareness has been primarily led by the combined efforts of the Food and Agriculture
Organization (FAO) and World Health Organization (WHO) of the United Nations (UN).
FAO organized this workshop to build on these efforts with a particular focus on South Pacific
island communities, which face an array of health and nutritional challenges associated with
inadequate fruit and vegetable consumption.
The importance of horticulture on human health and nutrition was also reflected during the
sessions of the 29th International Horticultural Congress (IHC2014) that was held in Brisbane,
Australia, in August 2014. The IHC is the world’s preeminent congress on horticulture science
and, as such, attracts expertise from research through to education and policy, from both
developed and developing countries, to exchange ideas.
The Secretariat of the Pacific Community co-hosted IHC2014 –along with the Australian
Society of Horticultural Science and the New Zealand Institute of Agricultural and Horticultural
Science under the auspices of the International Society for Horticultural Science– providing an
ideal opportunity to highlight the region and focus on its unique challenges. The importance
of health and nutrition and the consumption of fruit and vegetables were discussed extensively
in this wider context.
The workshop in Fiji, comprised of a three-day agenda and a field visit, organized within the
framework of the FAO-WHO Joint Initiative on Fruit and Vegetables for Health continued this
discussion. It was the first workshop under this crucial Initiative to focus on the South Pacific
region. FAO partnered with WHO, SPC, ACIAR, ISHS and the University of Tasmania to
organize this workshop. The workshop’s six main objectives were to:
1. create awareness about the FAO-WHO Joint Initiative on Fruit and Vegetables for Health;
2. document the production and consumption of fruit and vegetables and their current position
in the market in the South Pacific;
3. map existing policies and current programmes and activities for the promotion of fruit and
vegetables in the South Pacific;
4. follow up on relevant national level actions set within the Pacific Food Summit Framework
of Action for the countries that have laid this out — identifying current challenges and needs
to move forward towards realization — and assist those that have yet to develop action plans,
drawing on elements of the Kobe framework1 for promoting fruit and vegetables at national
level;
5. strengthen collaboration amongst sectors and actors promoting fruit and vegetable
production and consumption in the South Pacific; and
6. highlight critical food safety issues associated with production and consumption of fresh
fruits and vegetables.
The workshop’s opening technical session included a presentation on the results of a
widespread survey of vegetable and fruit production and consumption, and health and
nutritional challenges. The remaining programme included case study presentations and open

1
This framework gives guiding principles for a fruit and vegetable programme through a holistic approach. It was
developed during the FAO/WHO workshop held in Kobe, Japan in September 2004 — the first joint workshop
between health, nutrition and horticulture specialists.
1
 forum discussions with a particular focus on integrated strategies for combating relevant non-
communicable diseases, obesity, under nutrition and micro-nutrient deficiency. This workshop
built on the Framework of Action on Food Security in the Pacific2, which was endorsed by
the Pacific Food Summit held in Port Vila, Vanuatu, 21-23 April, 2010 and by Pacific Leaders
at their meeting in August 2010. Many of the country-level activities identified through this
Summit related to fruit and vegetable consumption. By building on previous and ongoing
programmes, this workshop introduced the FAO/WHO framework and provided guidance on
the development of national-level initiatives to improve availability and consumption of fruit
and vegetables.

Singapur cherry Muntingia

calabura leaves & fruits in
Secunderabad
© J.M.GARG

2
http://www.spc.int/lrd/publications/doc_download/1055-towards-a-food-secure-pacific-2011-2015

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2 Background

It is widely accepted that daily consumption of fruit and vegetables is important for human
health and nutrition because the vitamins, minerals, essential micronutrients, fibre, vegetable
proteins and biofunctional components they provide are crucial for human bodily function.
However, despite this recognition, worldwide per capita consumption of fruit and vegetables is
estimated to be 20-50 percent short of the minimum level recommended by FAO and WHO
(FAO, 2006). Such a deficit has severe consequences for human health and according to WHO,
low fruit and vegetable intake is among the top ten identified risk factors for global human
mortality and poor health (FAO, 2004).
The poor health conditions, associated with inadequate consumption of fruit and vegetables
and lack of physical activity, favour the development of non-communicable disease (NCD),
obesity and micronutrient and vitamin deficiencies. NCDs include cardiovascular diseases,
diabetes, cancer and respiratory diseases; they are currently the cause of 6 out of every
10 deaths (FAO, 2006). It is often mistakenly assumed that NCDs are confined largely to
the developed nations. The situation is, however, more dire in the developing world where,
for example, twice as many deaths are caused by cardiovascular diseases than in developed
countries (FAO, 2006).
Low consumption of fruit and vegetables is often simplistically attributed to unhealthy diets
in developed countries and to poverty and food insecurity in developing countries. In reality,
barriers to adequate fruit and vegetable consumption differ greatly between countries/
communities. One region that faces an array of unique challenges is the South Pacific.
Fruit and vegetable intake in Pacific Island Countries and Territories (PICTs) is well below
the recommended level of five servings per person per day, or 400 g per day (Secretariat of
the Pacific Community, 2010). This, among other risk factors, contributes largely to the high
prevalence of NCDs, principally diabetes and cardiovascular disease. A major risk factor for
NCDs is obesity, a key concern in this region: over half the people in all of the PICTs are
overweight and ten of the most overweight and obese countries on earth are located in the
South Pacific (Mercer, 2007). Existing alongside obesity at astonishing rates are, however, under-
nutrition and micro-nutrient deficiency. In 2010, more than one fifth of children and pregnant
women were recorded as being anaemic in 15 out of 16 PICTs (WHO, 2010).
The geographical isolation of communities in the South Pacific region is a factor that greatly
limits access to fruit and vegetables. The region comprises 20 000 to 30 000 islands over the
Pacific Ocean belonging to 22 countries and territories. Since the population of the entire
region is only 9.7 million (of which 7.6 million live in Papua New Guinea), these countries are
characterized by small populations living in remote areas (WHO, 2013). The extreme isolation
of the Pacific creates logistical barriers to efficient fruit and vegetable trade and distribution.
Low soil fertility is another key concern, particularly in atoll nations.
The Pacific Island region experiences unique environmental challenges, such as extreme
weather conditions and rising sea levels, and socio-cultural issues, such as land tenure disputes,
that reduce productivity and availability of fruit and vegetables. Unemployment and more
sedentary lifestyles create situations where people are both inactive and poor.
Countries in the Pacific region are generally poor, with five of them classified as least-developed
countries (UNCTAD, 2012). Economic constraints also exist and include high and fluctuating
food and energy prices, poorly developed supply chains and infrastructure, and small national
economies.

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 The situation in the South Pacific region has not gone unnoticed. Local and international
initiatives have sought to address the need for increased fruit and vegetable consumption but
more must be done.
WHO’s Global Strategy on Diet, Physical Activity and Health (2002) has increased worldwide
initiatives addressing health and nutritional issues. The Strategy was endorsed in the Pacific
Islands in 2006. Other positive influences have been: WHO’s “5 A Day” Symposium, held
in Christchurch, New Zealand in 2004; the implementation of FAO’s Food Security and
Sustainable Livelihoods Programme and Regional Program for Food Security; the Australian
Center for International Agricultural Research’s (ACIAR) Pacific Partnerships and the Pacific
Agribusiness Research for Development Initiative (PARDI) Programmes; and the Australian
Agency for International Development’s (AusAid) Nutrition Project. All have contributed to
improve food and nutrition security in the region and to increase fruit and vegetable availability
and consumption. In most recently in the 2010 Pacific Food Summit, a framework for action
was elaborated that emphasized again the importance of fruit and vegetable consumption for
health, as well as the environmental and economic challenges faced for production and access.
It has also been discussed and addressed at the Global Forums on Non-communicable Diseases
in 2011, 2012 and 2013.
The Global Fruit and Vegetables for Health Initiative (PROFAV), was launched in 2003 in
Geneva by FAO and WHO in recognition of the importance of their consumption, as well
as underlining the importance of improved production capacity of local small holder farmers.
The first workshop took place in Kobe, Japan, in 2004 where a framework that could be
applied globally for implementing national level interventions was developed. Consequently,
regional “awareness creating workshops” were held respectively in Lisbon (Portugal) for the
lusophone countries, in Seoul (Republic of Korea) for East Asian countries, in Yaoundé
(Cameroon) for the French speaking countries of Africa, and in Arusha (Tanzania) for the
Anglophone countries of Africa. Successful national workshops have since been run in a
number of countries including Cape Verde, Ghana and Argentina. This workshop in the Pacific
followed the work done on fruit and vegetable consumption for health in the region, identifying
challenges the countries are currently facing and sharing lessons learned from other PROFAV
regional or national initiatives, working together to move a step forward towards achieving
improved health for the population in the region.

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 3 Meeting report, conclusions
and recommendations

>>> 3.1 Introduction

The Pacific Regional Workshop on Promotion of Fruit and Vegetables for Health (PROFAV-
Pacific 2014) was held in Nadi, Fiji, from 20-23 October 2014. The workshop was organized
at the Tanoa Hotel by FAO with the support of WHO, Secretariat of the Pacific Community
(SPC), ACIAR, International Society for Horticultural Science (ISHS) and IHC 2014.
This workshop was organized within the framework of the FAO-WHO Joint Initiative on Fruit
and Vegetables for Health. It brought together 27 experts including policymakers, programme
managers, scientists and development practitioners, representing the sectors of health,
nutrition, horticulture, agriculture and education from nine Island countries of the Pacific
region which included: Cook Islands, Fiji, Kiribati, Republic of Marshall Islands, Niue, Samoa,
Tonga, Tuvalu and Vanuatu (see Annex 2). Representatives from the organizing, supporting and
technical partners were also present, including FAO, WHO, SPC, ACIAR and the University of
Tasmania, Australia. The meeting was opened by the Permanent Secretary of the Ministry of
Agriculture of Fiji, the Host Country.

>>> 3.2 Workshop process

The FAO/WHO framework was introduced during the plenary sessions and was followed by
presentations on specific topics. These included the importance of fruit and vegetables for
public health and food safety; the nutritious leafy vegetables research activity in the Pacific; the

Rambutans
© MUHAMMAD MAHDI KARIM

5
 mismatch between consumer-demand, health, and supply of fruit and vegetables; the WHO
STEP wise approach to Surveillance (STEPS) methodology on the major health risk factors
for Non Communicable Diseases (NCDs); and the challenges and strategies for increasing
production and consumption of fruit and vegetables in the Pacific Islands.
Two keynote/Case Studies were presented from Fiji and Samoa. Furthermore, the preliminary
analysis of the pre-workshop questionnaire on the status of fruit and vegetable production
and consumption in countries of the region was also presented. A field visit to horticultural
service installations and a research centre near Nadi was organized as part of the workshop
programme.

>>> 3.3 Conclusions

• According to WHO STEPS surveys on chronic disease risk factors conducted in most Pacific
Island countries and in line with existing FAO data, fruit and vegetable (F&V) consumption
levels are generally well below the recommended daily intake of 400 g/person. This low
consumption of fruit and vegetables is a major risk factor for NCDs, principally diabetes and
cardiovascular disease, and also for micronutrient deficiency-related health problems.
• Precise and location-specific data on production, consumption and availability of fruit and
vegetables are lacking or weak for many Pacific countries. There is a crisis in the region
resulting from the rise of unhealthy food consumption patterns and obesity, considering their
links to NCDs. Paradoxically, excess consumption of calories co-exists with under-nutrition,
constituting the so-called ‘double burden’ of malnutrition.
• It emerged that national institutions in most countries of the region have established
strategies for NCD prevention and have been implementing programmes to advocate for
healthy diets and lifestyles with increased consumption of F&V within these strategies.

Calophyllum inophyllum (tamanu tree)

© JOJAN

6
• Nonetheless, strengthened efforts and greater integration of activities among horticulture,
nutrition, health and education stakeholders is considered essential for the effective
promotion of F&V for health, particularly through a multistakeholder approach. It is
important to strengthen joint efforts between the public and private sectors towards
improving production, availability and utilisation of nutritious F&V.
• NGOs, civil society and especially faith-based organisations, can play a key role among
stakeholders in increasing awareness and facilitating programmes to improve availability and
consumption of F&V, and should be engaged through inclusive consultation mechanisms.
• It was found that island countries of the Pacific generally face challenges in securing adequate
year-round supplies of fresh F&V. Factors affecting local production capacity, and F&V
availability, include an ageing farming population, land availability and access, land tenure,
reliable water supply, access to seeds and planting materials of adapted species and varieties,
pest and disease problems, declining soil fertility, transport and high post-harvest losses, and
lack of use of guidelines and standards for food and nutrition.
• Specific constraints and challenges for atoll agriculture, often coincide with extreme pressure
on limited land and water resources and climate pressure, isolation, and low availability of
fresh F&V, were found to justify strengthened efforts on research for more productive and
sustainable local F&V cultivation systems.
• More can be done to enable local production, especially at household level, by considering
a range of technologies and systems, including agroforestry-based approaches, container
gardening and water management technologies (e.g. water harvesting, grey water recycling,
relocation of pulaka pits etc.).
• The workshop recognised the importance of stepped-up advocacy, information and
community education in changing the mindset of people in order to enhance the appeal
of F&V as a healthy diet choice. Different approaches were considered to be useful in this
connection, including:
o mobilising champions and role models;
o making schools healthier by serving F&V in school meals and canteens;
o demonstration of garden approaches and cooking demonstrations in multiple social
settings;
o exposing school children to realities of good farming; and
o educating children about benefits of F&V from an early age as a component of school
curricula and school meal programmes.
• School gardens are also considered to be an important entry point for developing healthy
diets, incorporating nutritious, local and traditional F&Vs.
• Adopting simple incremental and reachable population goals such as “increasing F&V intake
by at least one serving per day in the next 3 years” can help to bring the recommendations
of national dietary guidelines down to a level of popular understanding.
• Food safety of F&V produce is very important and must be addressed through integrated
approaches from field to table. This would require standards setting, compliance control
and training and education so that all stakeholders along the food chain understand how to
produce, handle and consume safe F&V.
• Various programmes are being promoted in Pacific island countries on traditional local
vegetables as good sources of micronutrients. These are based on local production of
adapted carotene-rich vegetables and fruit, such as Orange Sweet Potato (OSP), yellow and
red bananas, papaya and leafy vegetables. These initiatives could be scaled up for enabling
higher year-round production and consumption of a range of F&V, especially from home,
school and village gardens.
• Emphasis needs to be given to encouraging capacity building through farmer training
on good agricultural practices (GAP), including integrated pest management (IPM), for
sustainability and food safety along the value chain. Useful approaches include farmer field
schools, demonstration based training and the use of farmer-to-farmer mentoring.

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 • Measures such as farm field days, show and diversity days, and produce competitions, can
also be useful ways of promoting uptake of improved technology and raising awareness
among farmers and consumers on the benefits of F&V production and consumption.
• Better management and reduction of pesticide use is needed through more widespread
adoption of IPM practices, supported by effective regulatory processes and knowledge about
non-toxic plant protection products and measures. It is also critical to prevent the illegal trade
and use of unregistered pesticides in the region.
• There should be greater use of available biodiversity enabled by research, capacity building
and local selection and breeding programmes; furthermore, measures to enable the exchange
of plant material among countries need to be adopted.
• Further work needs to be carried out to increase knowledge on food preparation and health
benefits of local, traditional and indigenous F&Vs.
• It is important to address prejudices against the consumption of vegetables and/or fruit and
ensure men, women and children are targeted in F&V promotion campaigns.
• Improved F&V availability and reduced losses should be addressed also through a supply
chain approach involving improvement of collection centres, better storage, including
traditional methods, and communication along the supply chain making use of information
and communication technologies (ICTs).
• Good baseline data to characterise production, supply and consumption of F&V is needed in
order to be able to monitor changes and improvements. Equally, data on people’s knowledge
about benefits and consumption habits should be collected and monitored.
• There are a number of opportunities that can be used to advocate PROFAV messages, for
example, the high-level health and agriculture ministerial fora in the Pacific countries, as well
as global fora, International Conference on Nutrition etc.
• Countries need to consider means and incentives to reverse the trend of an ageing farming
population and to attract and retain youth in agricultural production, by changing the
perceived status of agriculture from low-paid hardwork to a technology-oriented and
business-driven occupation.
• It is important to integrate with, and add value to, existing agriculture, health and education
programmes, especially those focused on NCD prevention and F&V supply chain efficiency
improvement.

>>> 3.4 Recommendations

To participants:
• To brief their respective ministries, maintain and strengthen communication among
sectors to establish a multi-stakeholder country team or identify an existing coordinating
mechanism (e.g. NCD committee) that could facilitate implementation of the workshop
recommendations.
• To establish a networking mechanism that will enhance the interaction across sectors
(horticulture-health-education) in-country and among Pacific island countries on PROFAV,
using tools such as an e-newsletter-based communication strategy, improved web-based
availability of information, etc.
• To identify a lead person per country to facilitate joint planning and follow up on the
implementation of activities and progress monitoring mechanisms that the multi-stakeholder
teams identified during the workshop.
• To facilitate the completion of the PROFAV assessment through the questionnaire and its
analysis by FAO.
To governments of participating countries
• To promote the PROFAV agenda within the context of all relevant national policies and
strategies, as well as regional and global high level inter-governmental fora.
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• Specific policies and resolutions made at this level will increase awareness among the
international community and development partners and assist countries to adopt effective
elements of the PROFAV initiative.
• To implement the Global Strategy on Diet, Physical Activity and Health (endorsed during
the Fifty-seventh World Health Assembly [WHA57.17]) which states that national food and
agricultural policies should be consistent with the protection and promotion of public health
and to promote better diets along with increased physical activity.
• To build and strengthen human resources and institutional capacities that will be required
to reach the goals of the PROFAV framework. This could also be a potential area for
development assistance.
• To utilise surveillance and monitoring systems in the development of strategies, plans and
programmes on F&V and in the evaluation and impact assessment of such programmes.
To development partners
• To support the planning and implementation of national and regional horticulture, education
and health policies, and the PROFAV framework.
• To facilitate information sharing at operational level among countries, enhance availability of
existing, relevant information and resource materials, and support member countries in the
development of networking mechanisms.
To NGOs, Private Sector and Civil Society Organizations
• To join and support the PROFAV initiative and become active stakeholders in the definition
and implementation of its agenda.
To sponsor and partner PROFAV organisations
• FAO Headquarter, regional and country offices, SPC and ACIAR to work together in
providing support to countries in increasing F&V consumption and promote the PROFAV
initiative while encouraging countries to implement it.
• To encourage new development partners to join and support countries in the implementation
of the PROFAV agenda.
• To bring the countries and stakeholders that were unable to participate in the Nadi workshop
up to date and engage them in the follow up process.
Agreed on 23 October 2014, Nadi, Fiji Islands.

Breadfruit
© AUSTRONESIAN EXPEDITIONS

9
 Noni fruit (Morinda citrifolia)
© THE PHOTOGRAPHER

10
 4 Presentations

>>> 4.1 Promoting health through horticulture

Alison Hodder, Senior Horticultural Officer FAO, Plant Production and Protection Division, Rome, Italy
Fruit and vegetables are excellent sources of essential vitamins and minerals (A, folate, C, E and
potassium), fibre and vegetable protein. It has been estimated recently that 14.9 million pre-
school age children and 21 percent of pregnant women in developing countries of the Western
Pacific are affected by vitamin A deficiency.
Fruit and vegetable intake in PICTs is well below the FAO-WHO recommended level of
five servings or 400 g/person/day. In PICTs, there is a high prevalence of NCDs; significant
incidence of obesity; and high incidence of under-nutrition and micro-nutrient deficiency
co-existing with obesity.
It is important to beware of generalisation in data interpretation. Figures that map fruit and
vegetable supply and availability at national level are at best vague and at worst unreliable. The
data at a local level is usually unavailable and much of the production and consumption is
effectively invisible. There is a need to fill these gaps and to keep in mind that supply does not
equal consumption. In order to address the gap in supply and consumption, it is essential to
understand the current consumption patterns and causal / motivational factors is essential in
any national campaign pro fruit and vegetables; allow for different attitudes/perceptions (fruit
vis-à-vis vegetable consumption); and address supply and demand deficits simultaneously and
through coordinated campaigns.
The challenge is to get F&V supply and demand growing in balance. This implies effectively
reversing the per capita supply/consumption trends; optimizing the supply chain; keeping costs
low and prices affordable; assuring the safety; applying a supply chain approach (from farm-to-
table); and tightening linkages to nutrition education and public health promotion
These goals, reflected in the FAO/WHO dietary guidelines, appear to have the general
agreement of the international health community. This is key when leveraging partnerships
because an over-arching framework is needed to facilitate working linkages and value-adding
around these very different areas of activity; linkages, partnerships, strategic alliances, platforms
are necessary to ensure an integrated approach to policy, strategy and technology development;
and public-private partnerships should be fostered.
FAO and WHO’s PROFAV initiative fosters capacity building and policy development
initiatives. It works toward building more resilient production systems and value chains for year-
round availability and access to F&V; promoting Good Agricultural Practices for safe, quality
F&V; adopting National strategic plans for the sustainable development of small scale and
intensive horticulture; building active, independent producer associations to enhance farmers’
role in R&D decision making; and providing support to create and use information/decision
support tools (e.g. Hortivar). The two main pillars of PROFAV are:
• Promoting production and consumption of F&V for improving health, helping to prevent
chronic diseases and nutritional deficiencies;
• Promoting the advancement of science and know-how in production, distribution,
consumption, and health benefits of fruit and vegetables.

11
 Under PROFAV initiative, the Kobe framework was developed. This framework was adopted
in Kobe, Japan in 2004. It aims to promote and support the fruit and vegetable sector from
field to table, capitalising on programmes and projects that are already underway. The strategy
it adopts aims to:
• build multi-sector consultation mechanism for F&V promotion: Agriculture-Health-
Education + private sector + civil society;
• track F&V supply and consumption, baseline for M&E and identification of groups at risk;
and
• design integrated programmes, build on on-going initiatives in horticulture, nutrition, public
health.
Some of the practices that are being applied to improve the demand and consumption for F&V
include:
• National Dietary Guidelines
• F&V in school meal programmes
• 5-a-day campaigns
• Promotion of home and community gardens
• Promotion of school gardens and nutrition education: children are current and future
consumers.
The Pacific region has been an early starter. Many initiatives are happening across the region,
thus making it possible to take stock of the current situation. This workshop provides the
opportunity to:
• map current policies, programmes and activities for promotion of fruit and vegetables in
each country;
• document production and the consumption of fruit and vegetables and their current position
in the market;
• build concrete action plans for implementing the FAO - WHO framework for the promotion
of F&V at country level;
• strengthen joint work amongst health, education and agriculture sectors for promoting F&V
production and consumption; and
• highlight critical food safety issues associated with production and consumption of fresh
fruits and vegetables.

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>>> 4.2 Importance of fruit and vegetables for public health and food safety
Peter Sousa Hoejskov, Technical Officer – Food safety & NCD, WHO Division of Pacific Technical Support
DPS, Suva, Fiji
The Pacific is currently facing a noncommunicable disease (NCD) crisis. Once, traditional/
local crops dominated the population’s diet; now, they have to a large extentbeen substituted
by processed foods.
The primary indicators of an unhealthy diet are:
• Oversupply of calories (kilojoules)- too much food, leading to high total energy intakes;
• Imbalance in macronutrients - too much fat and/or sugar and insufficient dietary fibre;
• Excessive intake of salt;
• Low intake of micronutrient and of fresh fruit and vegetables.
It is important to focus on fruit and vegetables because low fruit and vegetable intake is among
the top 10 risk factors for attributable mortality. Globally, about 2.7 million deaths could be
saved with adequate fruit and vegetable consumption; and fruit and vegetable consumption
helps reduce the risk of NCDs.
The adequate intake of fruit and vegetables as part of the daily diet helps prevent cardiovascular
disease and certain types of cancer. Fruit and vegetables are also associated with reduced risk of
obesity and diabetes. Micronutrient deficiencies can cause birth defects and weaken the immune
system. The recommended daily intake of fruit and vegetables is 400 grams, or five servings.

Litchi chinensis fruits

© B. NAVEZ

13
 TABLE 1
Who eats less than 5 servings per day in the Pacific (in percent)
Country Male Female
Vanuatu 58.2 65
Fiji 83.9 86.2
Tonga 92.3 93.2
Kiribati 99.4 99.6
Samoa 38.6 36.8
Cook Islands 83.5 79.9
Niue 94 91.9
Tuvalu n.a. n.a.
Marshall Islands 91.9 90.1
Palau n.a. n.a.

The challenges for increasing consumption are supply chain issues, convenience, social and
cultural issues, price structure and lack of awareness of health benefits. Food safety issues
associated with fruit and vegetables include biological, chemical and physical elements. Food
safety is important especially when consuming fresh and unprocessed products. There are
risks associated with food borne diseases. Pathogenic microorganisms can cause infections and
intoxications. Chemical hazards are also of concern since chemicals can be added or can be
naturally present. Thus, ensuring food quality and safety is a shared responsibility – producers
and farmers, government, and consumers.
In conclusion, fruit and vegetables play an important role in the prevention of NCDs; the
intake of fruit and vegetables in the Pacific is low; measures need to be put in place to promote
local production and increased consumption of fruit and vegetables; and food safety assurance
is key for expanding production and consumption.

14
>>> 4.3 Promoting nutritious leafy vegetables in the Pacific and Northern Australia
G.H. Lyons, University of Adelaide, Waite Campus, Glen Osmond, Australia
R.G. Goebel, Etty Bay Exotics, Mourilyan, Australia
P. Tikai, World Vegetable Center (AVRDC), Honiara, Solomon Islands
K-J. Stanley, Women in Business Devt. Inc., Apia, Western Samoa
M. Taylor, University of the Sunshine Coast, Maroochydore, Australia
A more traditional lifestyle, especially with respect to diet and exercise, is needed to address
the alarming rates of obesity, heart disease and diabetes in Pacific Island countries and
indigenous communities in northern Australia.
Leafy vegetables should play an important role but Ceylon spinach (Basella alba)
are often regarded as “low status” foods and have
received little research attention.
This study found that, although certain leafy
vegetables are popular in some countries,
particularly Solomon Islands and Tonga, there
is little knowledge of their health benefits. Leaf
samples were collected in Solomon Islands, Samoa,

© G.H. LYONS
Tonga, Kiribati, North Queensland and the Torres
Strait Islands and minerals, carotenoids and
polyphenols were analysed. To study genotype-
environment interaction, different species growing
at the same location (same soil) and common
species growing at multiple locations (different Aibika/sliperi kabis
soils) were included in the survey. (Abelmoschus manihot)
The data, together with flavour and popularity,
were used to make a “Top 12” nutritious leafy
vegetable factsheet series, which was distributed
in participating countries and published online
(www.aciar.gov.au/News2013July). Outstanding
species included Abelmoschus manihot (aibika, bele),
Polyscias spp. (ete), Sauropus androgynus (sweetleaf),
Moringa oleifera (drumstick tree) and Basella alba
(creeping spinach).
Aibika was high in iron, zinc, magnesium,
© G.H. LYONS

manganese, protein and lutein; sweetleaf was high

in iron, zinc, calcium, magnesium, manganese,
sulphur, lutein, b-carotene and protein; ete was
high in zinc and calcium and grows well on alkaline
coral soils; drumstick was high in b-carotene,
sulphur and selenium, and creeping spinach was Drumstick nursery on
high in magnesium and polyphenols. Thursday Island, Australia
Reliable provision of quality germplasm, more
nutrition education, including school food gardens
which feature the most nutritious vegetables,
and value chain research to improve shelf-life
and delivery of nutrients to consumers are
recommended.
© G.H. LYONS

15
 >>> 4.4 A case study: The mismatch between consumer-demand, health, and supply
of fruit and vegetables in Tasmania (Australia) and in Papua New Guinea
Alistair Gracie, Tasmanian Institute of Agriculture, School of Land and Food, University of Tasmania,
Tasmania, Australia
Mark Boersma, Tasmanian Institute of Agriculture, School of Land and Food, University of Tasmania
Tasmania, Australia
The fundamental and vital role that fruit and vegetable consumption plays in human health
and nutrition is well established. In Australia, national initiatives to change consumer behaviour
to increase the proportion of fruit and vegetables consumed in diets, such as the “Go For
2&5”, have experienced limited or only regional success. While the Australian population still
consumes less than the recommended level of fruit and vegetables this is generally not due to
production nor supply limitations.
This is the case in Tasmania, where a nexus of social, economic and cultural driver have resulted
in per capita reductions in fruit and vegetable consumption over the last decade (Tasmanian
Government, 2013). Social, economic and cultural impediments to fruit and vegetable
consumption are discussed in the context of government, non-government, and producer-
based initiatives to promote consumption of fruit and vegetables.
TABLE 1
Adequate fruit consumption by sex, 18 years and over, Tasmania 2009 and 2013
Adequate fruit* 2009 2013
% 95% CI % 95% CI Significant
Males 42.9 [40.4, 45.3] 36.8 [33.9, 39.7] Y
Females 56.4 [54.4, 58.4] 51.5 [49.2, 53.8] Y
Total population 49.8 [48.2, 51.4] 44.2 [42.4, 46.1] Y
* 2 serves daily: Tasmanian Population Health Surveys 2013

TABLE 2
Adequate fruit consumption by sex, 18 years and over, Tasmania 2013
Adequate fruit* 2009 2013
% 95% CI % 95% CI Significant
Males 7.0 [5.9, 8.2] 5.9 [4.8, 7.2] N
Females 14.7 [13.4, 16.1] 13.5 [12.1, 15.1] N
Total population 10.9 [10.1, 11.9] 9.8 [8.8, 10.8] N
* 5 serves daily: Tasmanian Population Health Surveys 2013

In contrast to Australia, most of Papua New Guinea’s population (87 percent) live in rural
areas, and approximately in 1 in 6 people live in severe poverty. Households in PNG historically
produce the majority of the food consumed, and while this provides much of the dietary
requirement for carbohydrates through starchy root crops, malnutrition in widespread and
prevalent as their diets are generally deficient in proteins, fats, vitamins and minerals (Bourke &
Harwood, 2009). Non communicable diseases are widespread and, alarmingly, nearly one third
of the children under the age of 5 years in PNG are stunted due to malnutrition (WHO, 2011).
Addressing the malnutrition challenges of PNG, a country that is geographically and culturally
diverse with low literacy rates, is complex and requires an holistic approach that considers the
local, cultural values, economic status and education and social elements.

16
>>> 4.5 Improving the nutritional status of the population in Fiji
Ateca Kama, National Food and Nutrition Centre, Ministry of Health, Suva, Fiji
Fiji is beset with serious but preventable nutrition-related diseases caused by diabetes, coronary
heart diseases, high blood pressure, anaemia and under-nutrition in children. These preventable
conditions burden the economy with excessive medical cost both in relative and absolute dollar
terms and a significant loss of human development potential and work productivity.
Research in Fiji has clearly shown that a major cause of all prevalent non-communicable
diseases in particular childhood obesity and nutrient deficiency diseases has been the change to
poorer quality diet and lifestyle as a result of development and modernization.
Findings from the 1993 and 2004 NNS showed the problems of infant malnutrition,
underweight children, anaemia and overweight in many adults leading to heart diseases and
diabetes appear to be worsening. For example, more than 60 percent of the total population
were found to be of unhealthy weight; either overweight, obese or underweight.
Overweight and obesity in 1993 was 33 percent but the 2004 NNS found the rate was
56 percent; overweight in children tripled in 2004 compared to the 1993 NNS. Overweight is a
major risk factor for coronary heart disease and type 2 diabetes, and its association with both
diet and lifestyle.
Anaemia rates among the population increased to 32 percent in 2004 from 27 percent in 1993.
Forty percent (40 percent) children under 5 years were anaemic in 1993 but the proportion had
increased to 50 percent in the 2004 NNS.
Results of the 1993 and 2004 National Nutrition Surveys indicate a shift in preference from
nutritious traditional vegetables and fruits to more introduced and imported varieties.
Food Balance Sheet data spanning the period 1992-2009 on major sources of calories from the
available food supply clearly showed that cereals are replacing root crops as a source of energy.
Available information indicates a downward trend in the production of traditional food crops
for local consumption and a subsequent increase in the consumption of cereals such as flour,
flour products and rice.
The total calories available per capita per day from the food supply have increased from
2 819 in 1985 to 3 421 in 2009. Calories from imported foods in the last decade increased from
55 percent in 1999 to 68 percent in 2009. The major increase in 2009 was attributed to a high
importation of cereals, dairy and vegetable fat and oil.
Government’s recognition of the importance of nutrition in development, and the need for
intersectoral action to improve the food and nutrition situation of the country, led to the
endorsement of the Fiji Food and Nutrition Policy 2008 and Fiji Plan of Action for Nutrition
2010-2014 by Government.
The Fiji Plan of Action 2010-2014 will be evaluated though the National Nutrition Survey
2014. The timing is a perfect fit with the need to assess the effect of the nutrition intervention
strategies contained in FPAN. The proposed study will determine whether the strategies have
had impact on the nutritional health of Fiji’s population. The survey findings will be used to
inform future evidence informed policies, surveillance and nutrition interventions.

17
 >>> 4.6 Survey report: Barriers to the promotion of fruit and vegetable production
and consumption
Minwook Kim, Agricultural Officer, FAO, Plant Production and Protection Division, Rome, Italy
The purpose of this survey was to assess the barriers to the promotion of fruit and vegetables
production and consumption in the Pacific Region and to introduce a framework for promoting
fruit and vegetables at national level. Eight countries in the Pacific region – Cook Islands, Fiji,
Kiribati, Marshall Islands, Niue, Samoa, Tonga and Vanuatu – participated in this survey.
Among these countries, Kiribati, Marshall Islands, Samoa and Tonga have national platforms
that participate in various sectors for promoting fruit and vegetable production, supply and
consumption, except in the area of consumers’ association.
Most countries have divided their agricultural and nutrition/health goals into short and long
terms. However, the goals do not appear to be strictly related to fruit and vegetable promotion
because they are too general (i.e. food security).
The most general barrier to the promotion of F&Vs is related to economic issues – price,
income, land accessibility, labour resources etc. Other barriers included the lack of horticultural
technology and climate constraints, such as drought or excessive rains. Three countries ranked
climate constraints as their major general barrier.
According to consumer demands, lack of seeds and varieties is the major barrier affecting rural
smallholders, followed by human resources and limited knowledge. For mixed consumers, land
and income barriers are of concern, as well as the lack of technology. For market-dependent
consumers, the high prices of F&Vs are a major barrier.
Just two countries, Niue and Marshall Islands, have a horticulture development plan. Various
campaigns for promoting consumption of F&Vs have been undertaken by their governments
and NGOs, even though they need to be more proactive. Also, school gardens are very
common in the region.
Despite the fact that most of these countries do not have their own national food composition
tables or food-based dietary guidelines, some countries are using a dietary guideline developed
by the Secretariat of the Pacific community Health and Nutrition Division or FAO’s Food
Balance Sheets.
This result provides a partial picture of the situation, because this is solely based on the
responses of some countries. After the Pacific workshop, results could be modified following
participants’ response modification, and further statistical surveys should be carried out with
the cooperation of participants (see Annex 2).

Litchi chinensis
© LUC VIATOUR

18
>>> 4.7 Increasing production of fruit and vegetables in the Pacific Islands:
Challenges and strategies
Siosiua Halavatau, Deputy Director (Food and Nutrition Security Program), SPC Land Resources Division,
Suva, Fiji
Currently, a low fruit and vegetable consumption prevails in the Pacific Islands. For example,
in Tonga, nuts, fruit, preserved fruit and juice imports in 2009 amounted to 765.2 tons (worth
$2 582 677). The domestic supply of fruits in Tongatapu from Talamahu market and roadside
markets was 1 055 tons in 2010 and 1 333 tons in 2011, while 498 tons of vegetables in 2011.
The 2009 Household Income and Expenditure Survey revealed that only 5.8 percent of average
monthly expenditure is spend on buying fruits compared to 27.8 percent spent on meat and
23% on root crops and vegetable.
The challenges of getting fruits and vegetables to the plates include tradition – diets of Tongans
and Samoans did not include vegetables, but it did include some fruits; availability – much of
what is promoted are the “cool” seasonal fruits and vegetables - local production is a problem;
accessibility – Samoans and Tonga live in towns and farms are on the hinterland. – costs; not
bothered attitude; taste; lack of understanding – why they should eat; and preparation.
Although, Pacific smallholders are expert horticulturists for food security and commercial
horticulture, the horticultural sector is facing ecological, economic and sustainability crisis. There
are pests and diseases outbreak, and there is a decline in soil health and fertility. A hostile climate is
a challenging factor. The average temperature and rainfall suggest a benign environment but hide
temporal and spatial extremes; alternating cycle of El Nino and La Nina; extreme weather events
appear to be more frequent and more severe; and traditionally Pacific Islanders are coping with
these extreme weather events by having more resilient reserve crops like swamp taro, D. nummularia,
D. Bulbifera and Amorphophalus paeoniifolius.
The human factor also has an impact. There is a shortage of skills and information support
systems for horticultural research and development; a lack of entrepreneurs ready to take up
the opportunities offered by commercial Horticulture; a shortage of people with appropriate
formal skills and education to offer technical support; and traditional social system of land
tenure and community obligations – shifting cultivation systems - traditional horticulturists
are not accustomed to managing soil borne pests and diseases and declining soil fertility hence
abandon land to fallow.
The Secretariat of the Pacific Community (SPC) aims to provide more reliably productive crop
cultivars that are resistant to locally prevalent pests and diseases and adapted to Pacific climates.
CePaCT are traditionally vegetatively propagated crops that support the Go Local initiative.
SPC partners with USAID and ACIAR. It is developing tools and guidelines to support schools
in developing healthy school guidelines which will have a strong emphasis in promoting local
F&V intake. It is necessary to make a special effort to understand local social and economic
constraints, and time to introduce new knowledge and to change attitudes.

19
 >>> 4.8 Food Security in Samoa
Seve Sinei Fili, Ministry of Health, Samoa
Between 1963 and 2003, there have been significant changes in the supply pattern. Imported
cereals (mainly wheat and rice) have replaced locally produced root crops as the most
important source of energy. Furthermore, locally produced meat has been replaced by
imported meat. Food insecurity is an issue in Samoa. There is insufficient access to nutritious
food. There is limited access to “healthy” food in school canteens, and access to imported
fruit and vegetables are restricted due to high tariff rates. Most fruit and vegetables have a
20 percent tariff, while instant noodles, mutton flaps, sugar and salt are not applied a tariff.
Advertising influences food choices (reduces selection of healthy foods). Over 70 percent of
total food advertisements are aimed at children, and the majority of these are of “unhealthy”
foods.

FIGURE 1
Limited access to “healthy” food in school canteens
100
% of schools selling

80
60
foods

40 78
64
57
20
0 0 7 0
s
u

ts
it

ps

ies
ble
Ni

Fru

ee

po

ist
ta

Sw

Tw
Ice
ge
Ve

Foods

Diets have been shifting; there has been a change in consumption between 1991 – 2003. There
has been an increase in the consumption of rice, pancakes, cakes and chips; while there has
been a rapid decrease in the consumption of fish and papaya. There is a low fruit & vegetable
consumption, and the dietary habits of children are of great concern. In 2003, children
consumed more processed foods and fewer fresh fruit and vegetables when compared to adults.
In 2006, school children’s most common weekday foods included bread, doughnuts, cabin
biscuits, ice pops and instant noodles.
The current efforts to promote local fresh food include:
• Implement food & nutrition policy (Food & Nutrition Policy 2013);
• Implement and monitor healthy diet guidelines, e.g. Healthy Eating and Lifestyle Guidelines
for Samoa 2008;
• Promote fresh local foods e.g. fruit and vegetables, starchy root crops, e.g. TV and Radio
Spots and Ads;
• Improve food in schools and pre-schools, e.g. Samoa School Nutrition Standards 2012
(SPAGHL support).
Efforts to improve nutritional content of processed foods include:
• Update the food law to allow a focus on healthy food;
• Establish food standards to improve nutrition e.g. control fat, salt and sugar content of food
& fortify food;
• Work with business community to increase importation and sale of fortified foods.

20
Other efforts to improve food security and safety include:
• Develop standards for food labeling
• Incorporate food and nutrition in primary school curriculum
• Develop BHSC at the NUS (including nutrition)
• Conduct research on nutrition e.g. DHS, Brown University
Future possibilities are:
• Excise tax - increase on soft drinks and apply to other “unhealthy” foods
• Develop Code of marketing for children’s food advertising
• Review price control measures and place emphasis on “healthy foods”
• Remove import taxes for fruit & vegetables
In conclusion, Samoan diet has become more modern (increasing reliance on processed foods,
especially for children); the health consequences of concern are the increasing rates of lifestyle
diseases and micronutrient deficiencies; it is necessary to strengthen what we are doing -
educating consumers and promoting physical activity, strengthen sustainable production and
use of fresh local foods, and use innovative approaches related to food standards and their
effective enforcement; Ministries need to work closely together to improve nutrition, food
production and food quality with a multi-sectoral approach; and Samoa needs to work in a
harmonised manner with other Pacific countries.

21
 Psophocarpus tetragonolobus
(winged bean)
© CREATIVE COMMONS PINUS
 5
Kobe framework for promoting
fruit and vegetables at
national level

This framework was elaborated and endorsed unanimously by the participants of the WHO/
FAO workshop on fruit and vegetables for health, held at the WHO Centre for Health
Development, Kobe, Japan, in September 2004.
The framework will guide the development of cost-efficient and effective interventions for the
promotion of adequate consumption of fruit and vegetables at the national or sub-national
level. In this process, national or local production capacities, traditional agricultural and dietary
practices, prevailing patterns of nutrition, the health status of the population, and existing fruit
and vegetable promotion programmes need to be taken into consideration. This framework
includes general principles and examples of possible interventions for various consumer
domains, in order to appropriately tailor fruit and vegetable promotion programmes to the
target group(s).

>>> 5.1 Guiding principles for a fruit and vegetable programme

Globally the right to nutritious food and the will to end hunger and ensure food security has
been affirmed on several occasions. Article 25 (1) of the Universal Declaration of Human
Rights, adopted and proclaimed by the UN General Assembly in December 1948, states:
Everyone has the right to a standard of living adequate for the health and well-being of himself
and of his family, including food […]
In 1992, Ministers and the Plenipotentiaries present at the International Conference on
Nutrition, declared: We recognize that access to nutritionally adequate and safe food is a right
of each individual (FAO, 1992).
The World Food Summit Plan of Action of 1996 refers particularly to the production of fruit
and vegetables under paragraph 21, objective 2.3 (c) by calling on governments, in partnership
with all actors in civil society, to encourage, where appropriate, the production and use of
culturally appropriate, traditional and underutilized food crops, including grains, oilseeds,
pulses, root crops, fruits and vegetables, promoting home and, where appropriate, school
gardens and urban agriculture, using sustainable technologies […] (FAO, 1996).
Five years later, in 2002, the Declaration of the World Food Summit reaffirmed “the right of
everyone to have access to safe and nutritious food”. It emphasizes in paragraph 14 the need
for nutritionally adequate and safe food and highlight the need for attention to nutritional issues
as an integral part of addressing food security (FAO, 2002).
Fruit and vegetable promotion goes also hand in hand with Target 2 of the Millennium
Development Goals, which states: Halve, between 1990 and 2015, the proportion of people
who suffer from hunger (United Nations, 2014).

23
 The general principles of a national project to promote fruit and vegetables may include:
• availability
• accessibility
• affordability
• acceptability (quality, taste, safety, type of food, cultural sensitivity)
• equity (including underprivileged)
• holistic or integrative approach
• sustainability
• marketing/creating awareness of fruit and vegetables in foods and food programmes.
The establishment of a set of more specific guiding principles for a national fruit and vegetable
promotion programme may be shaped by the following general principles:
• A coordinated fruit and vegetable promotion programme should include initiatives which
target both demand and supply-side issues and should be based on a needs assessment.
• A fruit and vegetable promotion programme should be coherent with, and complementary
to, national policies and action plans such as food and nutrition, health, agriculture, and
environmental policies, if existing.
• A programme should attempt to mobilize existing resources (people, information, initiatives,
policies).
• A fruit and vegetable promotion programme should be socially inclusive and participatory.
From the beginning it should target all social classes through specific actions, and particularly
the poor.
• Messages should be consistent across policies and programmes. Every policy or intervention
should promote a healthy diet including increased fruit and vegetable intake (e.g. school meal
programmes or welfare food programmes should promote increasing fruit and vegetable
consumption as part of their provision).
• The main outcome should be increased consumption of fruit and vegetables by the target
group(s);
• An interdisciplinary, integrated, holistic approach should be followed in all parts of the
programme;
• The process and all interventions should be evaluated;
• Best practices should prevail.

>>> 5.2 Consumer domains and fruit and vegetable supply networks
An important issue in the design of intervention strategies is the fact that different types of
consumers (i.e. socioeconomic groups) acquire and utilize fruit and vegetables in different ways,
and there are different types of producers and suppliers. In order to design sound interventions
to improve fruit and vegetable intake, it is essential that the under-consuming population
groups are identified and efforts made to understand their consumption behaviours.
All consumer domains differ widely within and between countries. The characteristics outlined
below are not meant to be exhaustive, but to provide examples which may guide characterization
of consumer and supplier domains in specific countries and areas.

5.2.1 Characteristics of consumer domains and fruit and vegetable supply

networks

Fruit and vegetables are acquired in varying amounts and from various supply sources, ranging
from home production, through purchase in local, rural markets to supermarkets in urban
centres. Some consumers – they may be classified as autoconsumers – produce their own fruit
and vegetables.
24
Those who are totally dependent on markets to procure fruit and vegetables may be termed
market-dependent consumers and may be further divided into two distinct groups; those who
acquire fruit and vegetables for the needs of the household, and those for whom fruits and
vegetables are purchased and prepared by others, e.g. feeding programmes.
The latter category, loosely defined as institutional consumers, also includes consumers of
school and hospital meals, military and worksite catering, hotel and restaurant catering, etc.
Those consumers that both produce and purchase fruit and vegetables may be classified as
mixed consumers.
Similarly, different types of suppliers produce and market fruit and vegetables in different ways
and through different channels.
Smallholder subsistence farmers produce for themselves and possibly for a local market, while
small-scale commercial producers and large commercial firms produce mainly for markets both
near and far.
Specific characteristics of the consumer domains mentioned above are expanded below.

Rural smallholders producing fruit and vegetables for own consumption and
market supply
Characteristics:
• own production of fruit and vegetables;
• collection of fruit and vegetables;
• exchange of fruit and vegetables for other goods, including gifts;
• often task division between men and women; men produce cash crops, women produce fruit
and vegetables for own consumption around the house or in a small garden;
• vegetables consumed are more often home-grown; fruits, if consumed, more often
purchased.
The role of smallholders in the market is usually limited to selling very small quantities of
surpluses generated in local informal markets (in towns, along roadsides, etc.) that are within
an easily-reached distance. Selling may be direct, or through collectors (more common in the
case of fruits, spices).

Annona muricata
© DAVID EICKHOFF

25
 Mixed consumers – rural and particularly urban gardeners, but also dependent on
market supply
Characteristics:
• occasional fruit and vegetable producers, but their major income is non-agricultural;
• often belonging to low- to mid-income levels;
• may have limited knowledge of the nutritional value of fruits and vegetables and/or a
cultural bias against certain fruit and vegetables;
• commonly purchase fruit and vegetables from local markets or small shops;
• fruit and vegetables which they grow are limited in range and amount.
The local markets or small shops that typically supply mixed consumers are often small
operators outside the organized formal supply networks. They may comprise urban/peri-urban
growers selling their produce (which may include traditional and indigenous types in some
countries) direct in informal street markets, small–mixed grocery shops or stands selling a
limited range of seasonal vegetables and fruit acquired from wholesalers or producers.

Market-dependent consumers
Characteristics:
• dependent on cash economy, most of them living in urban or periurban areas thus they have
a limited ability to grow food;
• many women in this group work outside the home; hence there is less time available for food
preparation and a greater need for convenience and processed foods;
• part of food consumption is outside the home, less cooking takes place in the household;
• poor consumers in this group often purchase in small amounts because of a lack of cash;
hence are not able to benefit from supermarkets offering bulk purchases to reduce costs,
resulting in higher food costs;

Colocasia esculenta Taro

© DAVID MONNIAUX

26
• many do not have access to conditional transfers (transfers of resources to poor families on
condition that they engage in some behaviour, e.g. sending children to school, taking children
to health clinics), social safety nets or food aid programmes.
The supply network corresponding to this consumer domain is that typical of urban and peri-
urban areas, i.e. more or less specialized growers in rural or peri-urban areas with a source of
water, selling to collectors, processors, retailers either direct or through assembly or wholesale
markets, or sometimes direct to consumers through farmers’ markets.
The wholesale/retail chain, especially where supermarkets and specialized greengrocers
are involved, may be characterized by cold chains and transport of produce over distances,
depending on the country and region concerned.
Import–export of exotic and out-of-season commodities is a feature of the fruit and vegetable
supply chains in many countries. At the retail end of the supply chain there may be a range of
formal, well-organized operations, such as wet-markets, supermarkets, small greengrocer shops,
small-scale informal street and roadside stalls, and itinerant sellers.
Processed, semi-processed and pre-packaged fruit and vegetables can form a very significant
proportion of this kind of supply network, as can street food. Where there are formal market
supply chains, they may be subject to financial, fiscal, food safety and health regulations.

Institutional consumers
Characteristics:
• Schools – here the consumers are children and youth. Fruit and vegetables are acquired
through school meal programmes/government provisions, private companies, brought from
home or purchased at school.
• Worksites – here the consumers are usually healthy adults. Fruit and vegetables are usually
brought from home, bought on site (at cafeteria, vending machines, pre-paid programmes),
or bought outside e.g. fast foods/restaurant foods.
• Hospitals and care facilities, including child care and care of the elderly – here the consumers
are usually persons who are unwell or at high risk e.g. orphans/elderly. Fruit and vegetables
are provided as part of institutional meals.
• Military – here the consumers are usually healthy, young adults. Fruit and vegetables are
provided as part of set meals.
• Prisons – here the consumers may be at risk of malnutrition. Fruit and vegetables are
provided as part of institutional meals.
• Feeding programmes – here the consumers are at risk of malnutrition. Fruit and vegetables
are provided, in kind or through purchase vouchers, as part of the programme.
The supply network corresponding to this consumer domain is similar to that of market-
dependent consumers, although direct purchasing of fruits and vegetables from producers or
wholesalers may be more frequent especially where institutional use is large-scale, regular and
long-established.

5.2.2 Entry points for fruit and vegetable promotion programmes

This section outlines, according to the consumer domains established above, possible entry
points where fruit and vegetable promotion programmes could be initiated at country level.

27
 Rural smallholders producing fruit and vegetables for own consumption and
market supply
Entry points:
• Water – ensuring sustainable supply for plant growth.
• Eating preferences – promoting those fruit and vegetables that are known locally and widely
accepted.
• Women – empower women through:
- freeing time from other tasks to allow fruit and vegetable production and preparation
- providing financial support for fruit and vegetable production - education about health
benefits, and - inclusion of small-scale year-round fruit and vegetable production into
extension work.
• Schoolchildren – teaching children in rural areas to grow, prepare and consume vegetables.
• Local markets – providing education on production techniques/crop diversification, food
safety and health benefits.
• Encouraging use of simple technologies for production, postharvest handling and
conservation.

Mixed consumers – rural and urban gardeners, but also dependent on market
supply
Entry points:
• Own production and/or trade with neighbours – providing education on production
techniques/crop diversification, food safety and health benefits.
• Local markets – improving infrastructure of market; providing education on production
techniques/crop diversification, food safety and health benefits for consumers; methods to
improve post-harvest handling.
• Supermarkets/retailers – providing education on health benefits for consumers.
• Small-scale trade – providing education on marketing, food safety, health benefits for
consumers.

Market-dependent consumers
Entry points:
• Own production (where possible) – promoting fruit and vegetable growing e.g. in small
gardens (micro-growing).
• Local/urban (farmers’) markets – providing education on health benefits for consumers.
• Commercial suppliers, retailers/supermarkets – providing education on health benefits for
consumers.

Institutional consumers
Entry points:
Schools:
• Educating and instructing of parents through curriculum and parent–teacher associations.
• Identifying food items to be included and excluded from school environment, e.g. in lunch
(provided from home), changing choices in vending machines, specifying percentage of fruit
and vegetables to be included in school lunch programmes.
• Educating children and creating awareness about fruit and vegetables and what constitutes
a healthy diet e.g. through comics (example from Brazilian programme), posters and visible
reminders in classrooms.
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• Building children’s food skills, e.g. how to select fruit and vegetables, how to prepare foods.
• Producing, and teaching about, fruit and vegetables via school gardening programmes.
• Encouraging a clean environment; encouraging washing of food and proper hand-washing.
• Reviewing curricula e.g. including nutrition in science classes, home economics.
Worksites-for both large and small companies:
• Ensuring that fruits and vegetables are available, whether foods are bought or brought from
home.
• Providing minimum kitchen facilities for preparation of foods e.g. microwave or heating
implement, sink for washing, refrigeration.
• Changing choices available in vending machines, fruits, vegetables, dried, canned, fresh,
unsweetened 100 percent juices.
• Encouraging fruits and vegetables in cafeteria programmes.
• Organizing worksite programmes to increase nutritional awareness of workers; increasing
education of management that nutrition is important for healthy workers and productivity.
• Ensuring a clean environment.
• Providing reminders such as posters, educational materials, audio programmes, seminars,
recipes for healthy foods.
• Asking nearby restaurants to display healthy-diet posters and nutritional information for
available foods.
• Enforcing labelling of foods purchasable at the worksite.
These recommended entry points are also generally applicable to other institutional consumers
such as hospitals, prisons, armies, etc.

Pritchardia hardyi

© D. EICKHOFF

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 5.2.3 Barriers to fruit and vegetable promotion/consumption
Each country needs to identify potential barriers specific to their own situation but may
consider the following general barriers and those more specific to each consumer domain.
General barriers to fruit and vegetable promotion:
• climate – seasonality, water availability, extremes of heat and cold, drought, rain;
• lack of horticultural technology and knowledge of management practices;
• competing government priorities (e.g. policies promoting cereal production on arable land or
with available irrigation water);
• economic issues – price, income, affordability at a local and individual level;
• attitudes of producers;
• cultural influences on consumers – traditional diets and cooking practices (can be both
barrier and facilitating factor), cultural misperceptions affecting dietary preferences (e.g. fruit
causes diarrhoea);
• taste and habit formation of diet patterns in childhood;
• lack of awareness/knowledge of benefits of fruit and vegetables, of preparation of fruit
and vegetables, of what constitutes a balanced diet as income increases (role of increasing
meat/fat consumption), also misperception of advertised health claims of other products
(functional foods);
• unhygienic practices in production and preparation of food;
• perception or communication of food-safety risks – chemical or microbiological contamination
(should be emphasized relative to the risk in each country, where applicable);

Cashew apples
© ABHISHEK JACOB

30
 • misinterpretation or distortion of information by the mass media;
• introduction or rapid increase of fast-food culture; ready-to-eat fruit and vegetables are not
easily available, but ready-to-eat fast food is easily available;
• competition for funding with other promotion programmes, and with more popular foods;
• social acceptability of fruit and vegetable promotion interventions;
• lack of availability, inadequate marketing facilities;
• negative experiences with overproduction necessitating strategies for diversification, better
scheduling, value chain efficiency enhancement, and/or production shifts.

Rural smallholders producing fruit and vegetables for own consumption and
market supply
Specific barriers to fruit and vegetable promotion according to consumer domain:
• extreme poverty of producers and consumers
• low-quality varieties of crops (no crop improvement)
• non-availability of seeds/planting material
• human resource and labour constraints
• lack of basic enabling knowledge.

Mixed consumers – rural and urban gardeners, but also dependent on market
supply
• insufficient land and/or lack of urban/periurban land-use policies for horticulture
• low income
• lack of appropriate technology
• inadequate supplies of clean water and thus food contamination risks.

Market-dependent consumers
• high price of fruit and vegetables in retail outlets
• change in employment and lifestyle with urbanization; lack of time for preparation and
cooking as urbanization increases and more women work outside the home.

Institutional consumers
• acceptability and feasibility of promotional programmes
• interests of the institutional food provider competing with fruit and vegetable promotion.

>>> 5.3 Identification of stakeholders

The possible stakeholders to be involved in both promoting increased supply and demand
of fruit and vegetables are listed below. At the national level, each country should make an
assessment of its relevant stakeholders.

Public sector
• Ministry of Health – public health and health promotion
• Ministry of Agriculture, Food and Fisheries (horticulture development and marketing
departments, irrigation department, extension departments)
• Ministry of Education – research (university, scientific leadership), nutrition education
• Ministry of Social Development – food security, land reform
31
 • Ministry of Labour – worksite programmes, worksite hazards
• Ministry of Public Works/planning
• Ministry of Water Affairs
• Ministry of Transport
• Ministry of Environment
• Ministry of Women
• Ministry of Information/communication
• Ministry of Science and Technology
• Regional and local governments, municipalities (e.g. local land use planning, market
organization)
• Government department or agency responsible for food safety
• School and hospital administrations.

Private sector
• Agricultural input suppliers
• Producer organizations – small/ medium/ large or rural/periurban/urban
• Fruit and vegetable industry – processing, packaging, transport, (storage)
• Fruit and vegetable marketing associations – small and large retailers, wholesalers, shipping
companies, importers
• Media e.g. journalists’ associations
• Financial institutions – banks, micro-credit institutions
• Heads of companies
• Worksite management
• School and hospital administrations.

Nongovernmental organizations/civil society

• Community groups (including garden, women’s, cultural, and religious groups)
• Consumer groups
• Health promotion organizations (e.g. cancer, CVD), food-security, environment, agriculture
etc.
• Farmers’ cooperatives/associations, women’s producer groups
• Farmers’ unions
• Horticulture promotion groups e.g. fruit and vegetable associations
• Parent–teacher associations
• Traditional healers
• Community/religious/traditional leaders
• Health professionals’ associations (doctors, nutritionists, nurses).

International bodies
• WHO, FAO, UNDP, UNICEF, WFP, World Bank, IFAD, and their regional or national
representatives,
• Regional economic groupings e.g. European Union, African Union, Association of Southeast
Asian Nations, South African Development Community, etc.
• Bilateral donors

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 • Consultative Group on International Agricultural Research (International Food Policy
Research Institute and others).

>>> 5.4 National coordinating team

5.4.1 Constitution of national coordinating team

There is a need to ensure that a multisectoral coordinating mechanism, drawing upon existing
structures, is present to promote fruit and vegetable production, supply, and consumption.
When selected, members of this coordinating team should draw upon other stakeholders (yet
to be identified) and ensure visibility of the team.
The coordinating team should provide leadership at national level and define mechanisms for
its internal leadership.
The coordinating team could involve representatives from the following areas:
• agriculture/horticulture sector
• nutrition sector
• public health sector (e.g. public health nurse)
• education sector
• financial sector
• private sector in general
• farmers’ unions, smallholders’ associations (representing producers)
• consumers’ associations
• academic sector (especially for programme design and monitoring)
• local community leaders
• women’s groups.

5.4.2 Roles of national coordinating team

A range of possible roles for the coordinating team are proposed below. At country level, the
appropriate roles for the team need to be determined based on this list, to which others may
be added.

Thai eggplants in Guam

© PULLAO

33
 • To facilitate the development and implementation of national intervention programmes,
including resource mobilization.
• To create an environment for stakeholders to pursue these programmes with their respective
departments and institutions.
• To take responsibility to advocate for, and guide, policies and actions (including research and
extension) and strategies/action plans to be implemented by various stakeholders at various
levels.
• To coordinate action of different stakeholders.
• To monitor different programmes aimed to increase consumption and report on a regular
basis.
• The national-level coordinating team should be responsible for developing coordination at
different administrative levels, i.e. national, regional, municipal.

Points raised in the discussion

The Coordinating team:
• cannot develop policies, they can only guide
• should promote the decentralization process
• should have accountability and transparency
Leadership: could be joint, or rotating e.g. between Ministries of Health and Agriculture – but
should ultimately be left to the country to determine.

>>> 5.5 Identification of national goals and objectives

Goals will differ from country to country and, in particular, according to the kinds of nutrition-
related problems that fruit and vegetable promotion programmes are seeking to address.
General goals are suggested below:

Overall goal
To contribute to the prevention and control of NCDs and micronutrient-deficiency diseases
through increased production and consumption of a variety of fruits and vegetables.

Ripe jackfruit
© CHANDANA

34
Health goal
• Improve nutritional status, specifically decreasing micronutrient deficiencies and the risk of
under-, and over-nutrition, and hence the risk of NCDs.

Nutrition goals
• Increase fruit and vegetable intake.
• Bring individual consumption of fruit and vegetables to at least 400g per day in order to
decrease prevalence and incidence of chronic diseases and reduce micronutrient deficiencies.

Production goals
• Increase availability of fruit and vegetables.
• Increase production and/or availability of adequate amounts of fruit and vegetables to allow
consumers to achieve the medium and longterm recommended consumption goals.

Distribution goals
• Improve efficiency of distribution networks and marketing possibilities for small-scale
producers of fruit and vegetables through availability of transparent price information and
promotion of fair and sound practices by intermediaries.

5.5.1 Considerations regarding goal-setting

National programmes should establish realistic goals and timeframes, according to circumstances.
Beneficiaries should be the national population, i.e. consumers, with positive side-effects such
as improving socioeconomic status of producers.
Culturally-relevant fruit and vegetable consumption targets should be set, but they should
encourage people to increase the amount of fruit and vegetables they eat, preferably fresh or
adequately processed, e.g:
• 400 g/day minimum fruit and vegetable intake as population nutrient intake goal is an
important global long-term health target.
• Using the 400 g/day minimum goal as a short- or medium-term objective may not be
appropriate or achievable, for example in African countries where current consumption is so
low.
• It may be appropriate to set a target for the proportion of the population to reach the 400
g/day intake goal.
• Keeping numbers in the national objective may be useful but simply globalizing the ‘Eat
5 fruit or vegetables a day’ message (in short: “5 A Day”), used currently in many, mostly
developed, countries, is not necessarily considered appropriate. The ‘number’ goal should
be set nationally. Its presentation could relate to the number of meals in which people eat
fruit and vegetables, or number of plates (e.g. as used in Thailand), or number of portions
or number of different types of fruits and vegetables (e.g. as in several European countries
and the United States of America) depending on what is best understood culturally.

Objectives
When setting objectives at the national level to reach these goals, distinguishing between short-,
medium- and long-term objectives may be useful, as may differentiation between generic and
specific objectives. The following should serve as examples:
Short-term – to increase the number of people with home gardens by 20 percent within two
years.

35
 Medium-term – to increase productivity within existing gardens by 20 percent within five years;
to increase diversity of crops grown to at least six per household within five years.
Long-term – to increase intake of fruit and vegetables to recommended levels in the target group
within 10 years.

Further examples of specific and generic objectives

Specific
• Assess current fruit and vegetable consumption to identify and target groups with the lowest
intake by reviewing data or using rapid assessment techniques.
• Try to aim for the minimum recommendation of at least 400 g/person per day as the
population nutrient intake goal by (set time-frame and allow transition).
• Obtain introduction of policies for augmenting proportion of fruit and vegetables into
government food programmes.
• Decrease post-harvest losses and educate target groups about appropriate (according to
health needs and availability) conservation and preservation technology (e.g. solar drying,
pickling).
• policies on commerce and transportation e.g. small business development and marketing
reforms
• food and agriculture taxation policies
• national horticulture plan
• national poverty reduction strategy
• GAP policies (including proper and safe use of pesticides)
• donor programmes (bilateral and multilateral) and priorities.

5.5.2 Possible interventions at national level

General considerations
It is important to plan both production and consumption interventions in rural, urban and
peri-urban areas. The urban/peri-urban setting is very varied in countries regardless of their
income level, and even varies regionally within a country. The intervention(s) selected should
take account of the particular context in which they are to be introduced. When designing
interventions for a country it may be necessary to differentiate those related to fruit from those
related to vegetables, since different issues need to be tackled to increase consumption of each,
e.g.
• people generally like to eat fruits and they are easy to eat; constraints on their consumption
may often be related to price and seasonality
• vegetables need to be prepared, and it is necessary to educate people about preparing and
cooking them, as well as emphasizing the need for their increased consumption.
Every intervention programme should be based on a thorough needs assessment and should
incorporate an evaluation plan.

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 Examples of possible interventions
Examples of areas for action, possible interventions and programmes are provided in the tables
below for each consumer domain (target population).
Generic
• Increase and diversify fruit and vegetable production, quality and safety through:
- empowerment of women
- job creation.
• Increase availability and affordability of fruit and vegetables.
• Change knowledge, attitudes, behaviour.
• Change/increase amount and variety of fruit and vegetables consumed to ensure a better
general dietary pattern (accompanied by an improvement of general dietary pattern).
• Create an awareness within institutions of the need to increase fruit and vegetable
consumption.
• Sensitize civil society to the importance of fruits and vegetables through the media.
• Involve the community in services and programmes with nutritional aspects (e.g. provide
knowledge and funds to the community).

>>> 5.6 Activities at national level

EXISTING NATIONAL POLICIES AND ACTION PLANS
All countries have subscribed to the universal declaration of human rights, cited above, which
includes the right to food. Many countries have food and nutrition, or food security, policies
and/or action plans (see below) into which a fruit and vegetable promotion policy should ideally
be embedded. The multisectoral national coordinating team should identify relevant policies
and actions including finance, agriculture, health promotion, environment, food policies.
There may be a need to update, integrate or revise existing national policies (e.g. food security
policies) if they do not consider fruit and vegetables. For example: to include promotion of
vegetable gardens; to add fruit and vegetables to nutrition policies if the latter are focused
on cereals and pulses; to integrate fruit and vegetables in any way feasible in policies and
programmes on school feeding, and therapeutic and emergency feeding.

Pawpaw
© CCREATIVE-COMMONS-SCOTT BAUER-USDA-ARS

37
 The national coordinating team should also ensure relevant, practice-oriented research to
inform policy development.
Policies which may need to be taken into account when planning fruit and vegetable promotion
at national level include:
• food security policies and programmes
• nutrition policies (food-based dietary guidelines)
• agricultural (production) policies
• food safety and quality policies
• health policies
• NCD prevention and control policies
• education policies (health education policies) including school curricula
• credit policies
• input policies
• environmental policy
• family farming policy
• labour, land and water policies
Rural smallholders producing fruit and vegetables for own consumption and market supply.
Increase and diversify fruit and vegetable production to achieve year-round diversity, safety and
quality.

Pandanus-christmatensis
© CREATIVE-COMMONS-MICHAEL-COGHLAN

38
Build capacity for research for local adaptation, extension, planting-material multiplication, and
distribution, focusing on following key aspects:
• Safety and quality to increase intake:
- safe fruit and vegetable programme
- GAP - focus on pesticide use and prevention of contamination
• Cultivar improvement, selection and promotion: targeting nutrient content, quality, flavour:
- promote crops/varieties with high nutrient levels, e.g. yellow sweet potatoes, dark green
leaves, etc.
• Promoting techniques to extend production season:
- phasing production
- Water
Increase availability and affordability of fruit and vegetables.
Build capacity for:
• Technologies for post-harvest loss reduction
- harvesting technology
- processing technologies
- better storage
- packaging for freshness
- reducing domestic level losses through education of women
• Scheduling and managing production to reduce seasonal gaps and gluts to safeguard producer and consumer
price convenience
• Creating new networks to facilitate transport, haulage and marketing
• Increasing small grower involvement and benefit sharing through:
- promoting small farmer entrepreneurship
- promoting schemes for transparent price information and fair practices by intermediaries
- disseminating market information e.g. boards with prices in rural areas (as practised e.g. in
Mozambique)
- direct marketing (promotion of farmers’ markets) change knowledge, attitudes, behaviour
• Education programmes – for women, children, farmers, development agents, extensionists,
policy makers and planners, managers, subject-matter specialists
• Access to existing information and knowledge – ensure use of proper media
• Behaviour change – facilitated participatory planning
• Social marketing – produce marketing boards, where active, to support groups, programmes,
networks
Increase amount of fruit and vegetables consumed, replacing energy-dense, nutrient-poor
foods, where needed
• Use local media (especially radio), competitions, role play, theatre, marketplace exhibitions
• Educate mothers about a healthy diet at child-weighing or vaccination clinics, promote fruit
and vegetable consumption instead of nutrient-poor foods
Mixed consumers – rural and particularly urban gardeners, but also dependent on market
supply.
Increase and diversify fruit and vegetable production, quality and safety
• Collect, collate and disseminate information on successful gardening programmes
• Foster gardening networks, communities, clubs, etc.

39
 • Make land available for gardening in urban and peri-urban areas
• Organize training and extension programmes on gardening, nutrition, food safety, etc.
• Rescue traditional varieties/indigenous fruit and vegetables Increase availability and
affordability
• Improve marketing infrastructures
• Promote income-generating programmes
Change knowledge, attitudes, behaviour
• Organize media campaigns
• Review school curriculum and other national policies and strategies to support gardening and
educate about health benefits of fruit and vegetables
Increase amount of fruit and vegetables consumed, replacing energy-dense, nutrient-poor
foods, where needed
• Develop and promote simple small-scale food preservation methods at household level
• Promote recipes using fruits and vegetables
Increase and diversify fruit and vegetable production, quality and safety
• Work with peri-urban small-scale producers to identify types of fruit and vegetables that are
appropriate for these types of projects
• Supply-chain improvement projects addressing efficiency from seed/field through market
to table with appropriate technological innovation and information systems; need to take
account of food safety issues (use of safe water supply)
• Agricultural training in whole range of techniques and issues about efficient and safe
production; from production to preparation for sale. This should include education and
training about environmentally-friendly production methods
• Training to ensure that production or food preparation does not have unintended negative
health impacts
Increase availability and affordability
• Small scale production/ home production, food preparation and selling (for income
generation)
• Alternatives for commercialization – promote approaches to complement distribution
through supermarket chains
• Importance of specific policies to support such local supply
• Need to ensure food safety but without impeding small-scale producers from selling at
outlets such as street fairs, farmers’ markets, mobile markets from trucks
Change knowledge, attitudes, behaviour
• Education targeting women and men about:
- good nutrition and how to achieve this in the diet
- fruit and vegetables as part of balanced diet
- importance of fruit and vegetables for tackling micronutrient deficiencies in children
- prevention of CVD, obesity, cancer etc.
- safe preparation and culturally-appropriate cooking and storage techniques
• Mass media education campaigns to inform about the benefits of fruit and vegetables for
tackling over-nutrition, NCDs and micronutrient deficiencies. Increase amount of fruit and
vegetables consumed, replacement of energy-dense, nutrient-poor foods where needed
• Public education campaigns to promote increased utilization of fruit and vegetables in
restaurants (education regarding health benefits and how to increase fruit and vegetable sales)

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Market-dependent consumers
Three key areas of intervention are suggested:
• Communication, education and advertising – three approaches which target a wide population
but which tend to be expensive;
• More targeted interventions involving changes in the environment, i.e. through improving
access to, and availability of, fruit and vegetables – these require intersectoral action;
• Regulation, e.g. fiscal policies, regulation of health claims or advertising, facilitation of sound
health claims for fruit and vegetables.
Increase and diversify fruit and vegetable production, quality and safety
• Linked to institutional feeding programmes organized by the government e.g. for hospitals,
camps, armies, schools, correctional facilities, provide seeds and training to help local
communities produce fruit and vegetables for feeding programmes
• Supply-chain-based horticultural development projects to encourage farmers and peri-urban
growers in suitable areas to grow fruit and vegetables and benefit from value chains linked to
institutional feeding programmes
Increase availability and affordability of fruit and vegetables
• School-linked gardens:
- encourage the use of indigenous fruits and vegetables; teach both boys and girls how to
cook
- get parents and other adult members of wider school community involved
Change knowledge, attitudes, behaviour
• Engage public figures to promote increasing intake of fruit and vegetables (e.g. in Thailand
a royal figure is promoting health and nutrition, in the USA a senator is promoting fruit in
schools in his state)
• Link healthy diet with physical activities/sports
• Give recognition to NGOs and religious leaders working towards promoting better nutrition
• Education regarding cooking and preparation of fruit and vegetables for food workers in
communities, schools, restaurants
• Retain or (re)insert nutrition and cooking as part of the school curriculum
• School gardens – education regarding gardening and balanced nutrition

Bok Choy
© CREATIVE-COMMONS-JS

41
 • Field trips to local markets or supermarkets to educate school children about fruit and
vegetable availability
• Providing fruit snacks in schools and worksites (e.g. as offered in Denmark, Norway and the
UK)
Increase amount of fruit and vegetables consumed, replace energy-dense, nutrient-poor foods,
where appropriate
• School food programmes (at school and national levels; whether free, subsidized or paid
meals) tailored so that they increase fruit and vegetable consumption by schoolchildren
(i.e. as part of balanced diet, not just about under-nutrition), connected with supply-side
interventions to promote/support local production
• Government food programmes need to be consistent with national nutrition policies and
should promote purchase and consumption of fruit and vegetables.
Institutional consumers
General considerations regarding interventions that could be advocated as part of a national
agenda include:
• Specific strategies in schools, worksites and other institutions – must consider literacy, access
to media, rural or urban environment, gender roles, social roles, food industry, and national
policies.
• National policies should attempt to create a win-win situation, e.g. primary and food
industry may be encouraged to work with these programmes through the opening of large
government-brokered markets (e.g. school lunch programmes, and home-grown supply
schemes).
• In terms of gender roles, it is useful to get women involved in supply-chain optimization,
including education in the kitchen.
• Schools and hospitals are visible to the public; if they are not consistent and they promote
healthy diets but actually provide unhealthy food they undermine the whole programme.
Hospitals and schools represent a good opportunity to not only promote healthy diets but
also provide healthy food.

>>> 5.7 Sources of data and data collection

Collection of data on supply and consumption of fruit and vegetables should be integrated
into a national nutrition monitoring system (e.g. including anthropometry, food balance sheets,
food surveys). It is essential to collect or utilize (as far as possible) existing primary and
secondary data to understand current behaviours of consumers and producers. Many countries
already collect routine data on dietary habits, agricultural production etc. most of which can be
accessed and used when developing a fruit and vegetable promotion programme.
Ideally, the national coordinating team should include a specialist who can supply or collect these
data, or the team should plan or commission this work from the start. Collection of specific
data, using an appropriate methodology, may be required for an intervention programme. All
data collected should be made public and be used for the purpose of the programme.

General sources of data

These include:
• agricultural census reports;
• dietary intake surveys, including in institutions, where assessment of supply can also be
carried out if sources of fruit and vegetables are identified, e.g. cafeteria, brought from home,
bought outside;
• purchase data on food items bought by institutions e.g. worksites, hospitals, military
establishments.
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 Data provided by FAO and WHO
Helpful web sites to access data provided by FAO and WHO include:
FAO
General site to all statistics:
http://www.fao.org/waicent/portal/statistics_en.asp
WHO
InfoBase on risk factors for chronic diseases:
http://www.who.int/ncd_surveillance/infobase/web/en/
Micronutrient deficiency information system:
http://www.who.int/nut/db_mdis.htm

Methodology for data collection

General methodologies which can be used to collect data in all consumer domains include:
• World Bank/International Food Policy Research Institute survey technique
• participatory rural appraisal
• rapid rural appraisal.
Simple, valid and rapid tools are needed to collect data for all groups on supply and consumption
e.g. rapid appraisal tool.
Baseline data
Information that should be collected as baseline data, if not already available:
• what people buy and what they eat on a daily basis (by age, sex, household size, marital status,
income or educational status)
• where people obtain fruit and vegetables
• where people eat: home, restaurants, schools, worksites, street food
• how they eat (which form of food, cooking etc)
• cost of fruit and vegetables from different supply sources, and price of fruit and vegetables
compared with different food types.
Some general principles for data collection
• ensure that qualified persons (e.g. university researchers) are carrying out the data collection
and that the methodology is standardized and validated;
• sensitize researchers to the kinds of data needed, and avoid overly-complicated research;
• create a central databank in the country e.g. in bureau of statistics;
• link assessment surveys to monitoring and evaluation.

>>> 5.8 Monitoring and evaluation

The following general principles should be stressed:
• Create a culture of evaluation – build capacity for monitoring and evaluation.
• No programme should be contemplated which does not include a mechanism for
regular evaluation. Incorporate monitoring and evaluation into the planning, design and
implementation processes, and include a specific budget allocation for monitoring and
evaluation.

43
 • Define the monitoring and evaluation strategy during programme design, ensuring the
availability of baseline data and planning of initial surveys such that they can be used for
monitoring in the future.
• Use experts in the evaluation team (e.g. statistician, economist for cost-benefit analysis,
programme manager to determine what should be evaluated).
• Do in-process monitoring frequently, but formal evaluations to change guidance less often.
• Monitor all guiding principles: accessibility, affordability, etc.
• Ensure dissemination of evaluation results.

What should be monitored?

Monitor process (operational, implementation aspects), outcome (e.g. is fruit and vegetable
consumption increased), impact (e.g. on health) and cost-effectiveness.
Process evaluation
All programmes should include process evaluation for troubleshooting and to achieve effective
implementation, i.e. to:
• assess whether the programme is being implemented as planned
• identify constraints to implementation
• use information to improve implementation; identify, test, and implement corrective
measures as needed.
Outcome evaluation
This should be undertaken to assess whether intended outcomes have been achieved as a result
of project implementation.
Impact evaluation and cost-effectiveness
Careful, rigorous evaluation needs to be conducted to test impact and cost-effectiveness of the
intervention programme in different contexts.
However, this does not need to be done for all programmes because it tends to be cost- and
resource- intensive. The impact evaluation should focus on assessing whether the programme
has reached its stated goals, and also assessing success factors.

Selecting appropriate indicators

Process evaluation
Include indicators of
• targeting (e.g. whether the intervention is reaching its targeted beneficiaries)
• coverage (what percentage of the population is being reached)
• provision/delivery (whether the intervention is delivered as planned, what can be done to
improve operational aspects of the programme and make implementation more effective).
Outcome evaluation
Indicators that mark the outcome could be for example:
• whether fruit and vegetable consumption at the population or household level has increased;
• whether intake at the individual level has increased for different age groups;
• whether the availability of fruit and vegetables was increased.

44
Impact evaluation
Indicators are needed that illustrate if the intervention is meeting its stated objectives – for
example:
• whether nutritional status has changed (e.g. less deficiency of a micronutrient)
• whether risk factor profiles for NCDs are maintained or improving
• whether health status has improved.
Some indicators from ongoing surveys could be used, for example:
• dietary surveys for monitoring intakes
• biochemical indicators for monitoring micronutrient deficiencies
• anthropometric measures for monitoring obesity
• illness and hospitalizations for monitoring chronic diseases.

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Annex 1

Workshop conclusions

Based on the challenges identified through the assessment, as well as country case studies,
elements, entry points and next steps were identified for immediate, medium term (2-3 years)
and long term (3-5 years) action at country level through group discussions. Groups were
divided in accordance to the characteristics of the countries. The groups analysed and discussed:
• the policy and strategy environment related to availability and accessibility of produce,
production capacity, and supply policy; public health policy and system; education policy and
system – in terms of strengths and challenges;
• charting the challenge of increased F&V supply and consumption;
• elements of a framework for action; and
• strategies to foster and promote coordinated action

Key Conclusions from Group 1

Participants: Samoa (2), Tonga (1), Niue (2), Cook Islands (2) and Tuvalu (3)
Facilitators: Alison Hodder, Siosiua Halavatau and Graham Lyons
Session 1: Main health problems, challenges, characteristics and positive aspects (strengths) at
national level?
Challenges Solutions
• Obesity, aging farmer population, low fruits • Enact and strengthen food laws & regulations
and vegetables, physical inactivity, teenage for healthy diet and physical activity
pregnancy • National strategy on FV aligned to the WHO
strategy on diet, physical activity, and health
• Strengthen implementation of NCD policies &
strategies
• land availability and access to land • National Food Security framework
• Water availability for agriculture • Go Local campaign to promote production and
• Improper and abuse in use of pesticides consumption of local food

• Poor soil health and fertility, P&D problems

including roaming animals
• High post-harvest losses
• Climate change effects ; drought, sever
cyclones, salt-water intrusion
• Climate change – drought, salt water
inundation
• Lack of data around production, sales, Conduct surveys
consumption, price change

47
 Session 2: Constraints to Increasing F&V Production and Consumption and Target Groups
Constraints
• Lack of promotion of production of F&V
• Small land areas, inadequate water supply
• Water availability for agriculture
Solutions
• Key stakeholders including Agriculture,
Education, Health, Tourism, Hospitality
Training Centre, Business Trade and
Investment Board; community incl. traditional,
church leaders
• On-going commitment on F&V promotion
• All countries have NCD’s - review and assess
existing FS programmes and develop new ones
• Pacific food secure framework – adopted at
Regional Food Summit, Vanuatu 2010

• Land availability and access to land • Competent, credible, reliable, experienced

• Poor soil health and fertility, P&D problems
including roaming animals
• Improper and abuse in use of pesticides
• High post-harvest losses
• Lack of diversity in current production
• Lack of understanding of benefits in the
consumption on F&V
extension officers
• Farmer-to-farmer mentoring
• Strengthen regional programmes – exchange of
materials, ratify ITPGRFA
• Pictorial demonstration of 5-servings a day
• Target Kindergarten and primary school
students = 3-9 year olds
• Baseline data - study select population (school
students)
• Promote school food gardens; and include
nutrition and local F&V in the curriculum
• Peoples attitude and lifestyle important in
changing NCD

Session 3: On-going Programmes/Projects that fit the FV initiative at national level

Demonstration and celebrations
• Annual Agriculture Show, Show-day, World Food Day Celebrations
• Farmer field-days and demonstration plots
• Farmer Field Schools promoting alternatives for herbicides, IPM programmes
Programmes on nutritional aspects and health issues
• Health Nutrition promotion programme and FAO/SPC food security programmes
- Shift in diet – “good kaikai as opposed to rubbish kaikai”
- School garden and feeding monitoring – Agriculture, Health, Education
- Dieticians, nutritionists, agriculturists to know how to cook and plant
- Managing compliance with food standards/guidelines in school based programmes
- Short-term health changes in NCD risk factors (BP, BMI, Cholesterol, Blood Glucose)
- Long-term changes in NCD prevalent
• Utilise existing structures such as Nutrition Centres, Home economics in schools, hospitality
training centre

48
Partnerships
• Use of sports role models to promote FV
• Strengthen Public-Private Partnerships
Information collation
• Demographic health surveys; health census; health steps
• Fruits and vegetable baseline survey; market information survey
• Changes in land use, cultivation, production, sales
Session 4: Promoting co-ordinated action
Promotion of local fruit and vegetable production •
and consumption
increased production
Community social development
Food security and resilience
Involvement of stakeholders
Networking and information sharing
Chamber of commerce = links, supports,
structures, tourism board/authority , Ministry
of Trade= promotion of local FV, Go Local
• National food and nutrition co-ordinating
committee ; Health boards
• NCDs forum/roadmap; Food security/NCD/
working group
• Psychological “walk the talk”
• Farmers/growers associations = increased
production cater to markets, access capital/
funds, import of supplies (seeds, fertilizers,
chemicals)
• National community social development ;
Education, Churches, Village council Women
in business
• CC – Food Security, building resilience to CC
programmes
• Greater support from top level ministries
• To ensure active enforcement get KEY
stakeholders on-board and call others as needed
SPC, FAO, WHO – development partners
• USP and other Universities – capacity building,
national training
• ACIAR – research and development
• Networking among programme managers,
sharing information and experiences, health,
agriculture, education
• Need websites of FAO, SPC to make available
information
• FV for health newsletter
49
 Session 5: Describe specific actions that can be done in the 12-months following the workshop
and who/which institution would be responsible by acting
• Strengthen stakeholder collaboration at regional and national level
• Establish national steering committee on promoting F&V consumption - comprising of key
stakeholders (Agriculture, Health, Education, NGOs, Church, Community etc
- Committee chaired by high level delegate: Minister or PM
• Incorporation of F&V programme into national budget process
• Promote National projects to facilitate F&V
• Promote regional projects such as TCPs and others
• Advocacy through high level forum such as Agriculture ministers meetings 2015
• Pacific Health Ministers to advocate via International conference on Nutrition, FAO
Headquarters Nov ‘2014
• Establish Regional Platform for Food Security-Nutrition-NCD
• Strengthen capacity, knowledge, understanding of farmers, school students, health officials,
NGO’s and communities in F&V (teaching materials, school demonstration plots, backyard
and container planting)
• Strengthen research & development in fruit and vegetables - high and low-lying atoll islands
• Strengthen propagation and supply of planting materials to farmers and communities
• Encourage soil improvement options including composting, green manuring etc

Key Conclusions from Group 2

Participants: Marshall Islands (3), Kiribati (1), Vanuatu (3) and Fiji (2)
Facilitators: Makiko Taguchi, Alistair Gracie and Minwook Kim

Production/availability constraints Solutions

Year-round supply of F&V
Accessibility of good planting material
Declining soil health/fertility
• Increase diversity of F&V.
• Trial different systems of production. Promoting urban,
peri-urban production for home consumption (e.g.
containers).
• Domestication of indigenous F&V
• Fiji – government involved in seed production and
distribution.
• Private, local seed producers encouraged.
• Cooperation among countries facilitated by SPC, with
consideration given to biosecurity and certification
requirements.
• Improving and promoting composting practices (RMI)
• Educating farmers/locals about composting techniques.
• Promote use of pulses/legumes, intercropping etc that lead
to higher soil organic matter.
• Improving integrated livestock/plant production systems.

50
Production/availability constraints
Transportation, storage,
Short shelf life/Lack of processing
Lack of acceptance of local produce
Climate change/salinity
Pest and disease
Land availability
Farmer capacity (e.g. knowledge of
IPM strategies)
Low productivity
Solutions
• Improving cooperation/coordination among farmers.
• Government to support transport (year-round) and
construction of appropriate storage facilities.
• Collection centres.
• Creating local/village markets.
• Increase understanding among farmers on postharvest
handling practices.
• Build capacity in villages.
• Provision of small-scale technologies.
• Re-introduce traditional knowledge on storing F&V.
• Educate local populations of nutritional value.
• Re-introduce knowledge of culinary/preparation use in
local dishes.
• Improve convenience where possible (e.g. processing)
• Encourage local cuisines in local and tourist restaurants.
• Crop adaptability studies.
• R&D to develop saline and drought tolerant crops.
• Farming systems: container farming, hydroponics etc.
• Extension/knowledge sharing of IPM approaches,
including traditional methods and biological control
• Diversification, companion planting
• Promote GAP to avoid build up pesticide resistance
• Strengthen regulatory use of pesticides
• Enhance efficient use of agricultural land
• Promote backyard and front-yard/home gardening.
• Container/hanging gardening
• Foster greater extension via NGO’s, farmer organisations
• Using farmer field schools
• Tailoring extension to level of literacy/experience
• Demonstration/hands-on training
• Field days to “train the trainer” farmers – targeting lead
farmers
• Farmer competitions
• Economics
• Market access information
• Covered above in GAP, training etc.
• Incentives to encourage productivity.
51
 Production/availability constraints
Diversity of varieties
Poor extension services
Lack of coordination within supply
chain
Infrastructure
Lack of interest in agriculture/ poor
resource use due to emigration of
farmers
52
Solutions
• Long-term, strategic approach to crop breeding, selection
of indigenous varieties etc.
• Trial existing varieties
• Cooking shows and demonstrations, including via
dieticians etc
• Proactive approach to commercialisation of local/
traditional crops
• Increase ratio of extension officers to farmers
• Foster greater extension via NGO’s, farmer organisations
• Greater sharing of information/extension material among
countries
• Improve information sharing/communication along the
value chain.
• Using communication devices (eg mobile phones) to
improve information sharing to improve regular supply of
produce
• Improve understanding of existing supply/value chains
• Improve supply of water to farms: miracles, desalinisation
plants, water catchment systems, irrigation schemes,
recycling. Harvesting rainwater.
• Coordinated transport
• Collection centres with storage facilities etc.
• Government grants to encourage greater interest in ag
• Agriculture within curriculum (present in some schools
and countries)
• Strengthen links between education and agriculture
through career forums/expos
• Changing perception of agriculture from hard work with
low pay to technology oriented and business driven
• Promote agriculture shows and awards
• Success stories/role models
Country Priority plans Stakeholders Lead
Vanuatu Healthy school and correction Government Departments Dr. Roger Malapa
service settings:
• Target “pilot” schools and Dept. of Public Health Jean Jacques Rory/
surrounding communities Dept. of Agriculture Nellie Muru
(Peri-urban schools (focus on VARTC
boarding schools) Dept. of Local Authorities Fernand Massing
• Provide diverse range of plant Dept. of Education
material and technical support Dept. of Biosecurity
to establish gardens and foster
healthy eating habits. Local NGOs
LLEE (Live & Learn
• Target schools are primary and Organisation)
secondary WSB (Wan Smol Bag
• Work with health and Theatre)
agriculture teachers Farm Support Association
Red Cross
Care International
ADRA
Priority action agenda for
government. – to reach 2016 WHO
“Healthy, Wealthy, Educated UNICEF
Vanuatu” UNDP
VTWG
Support conservation of OP seed
SPC
lines
FAO
Promote IPM vegetable ACIAR
production practices
Establish breeding programme for
local indigenous fruit trees.

53
 Country Priority plans Stakeholders Lead
Fiji Health promoting primary NFNC Ateca Kama
schools WC Dr Isimeli Tukana
• Educating population on FPAN SC Mr Ilimeleki, CE MPI
nutritive value of indigenous HPS SC Mr Tikiko Lewesi
vegetables/fruit using mass FT TAG Dr Peter Hoejskov
media NA DN Mrs Jiutajia Tikoitoga
FIND Ms Ditoga
• School gardens including Nutrition CSN Kabukeinamala
vegetables and fruit trees FB HAG Ateca Kama
SPC Mrs Jowalesi Taukei
FAO
ACIAR
Health facilities MOA
• Cooking shows using local MOE Shalendra Prasad
cuisines by dieticians Farmer Association Mr Tikiko Lewesi
Consumer Council
• Establish fruit trees in hospital
garden AMA Josua Namoce
CLC Alifereti Yaya
FBO
Establish farming field schools Provincial structures
• Through existing programme

F&N policy developed next year

for 2015. PROFAV to fit within
this policy area
• FPAN 2016-2020 will include
details of programmes and
activities of PROFAV

54
Country Priority plans Stakeholders Lead
RMI Improving student understanding MOH Charlynne A. Alfred/
of nutritional value of F&V and R&D Carlinda Jabjulan
assessing learning outcomes using MOE Karness Kusto
MISAT. This will include: EPA Glorina Harris/
• better utilisation of primary and WUTMI Theresa Kijiner
secondary school gardens YTYIH Abraham Hicking
KUTMIT Kathryn Rilang
• education and training of FBO Aluka Rakin
schools, MOFA Janet Nemra
• pre and post MISAT NGOs Aindrik George
assessments and health aspects Wellness Center Ylissa Kendall
MIEPI Dr. Pinano
• cooking demonstrations
SPC Ray House
– traditional knowledge
FAO May Ipil
in preparing and cooking
ACIAR
indigenous fruit and veg.

Long term (order of priority)

• climate change (incl. pest and
disease, salinity, )
• promote home gardens
• capacity building farmers
• transportation (outer islands)
and storage (shelf life)
• diversity
• infrastructure
• soil health and fertility
Kiri Educate farmers on GAP MELAD-Agriculture Tianeti Benna –OIC
• making high quality composts MOE-Curriculum section Director
MHMS-Nutrition section Eretii Timeon
• planting techniques. NGOs: KOP, LLE, Ahling Onorio,
• cultivation of swamp taro using TOFMA Iataake Totoki
traditional knowledge SPC Mwamwarau Karirieta
FAO
• postharvest
ACIAR
Priority: Support ongoing research
on drought and saline tolerant
crops
• Provide tested planting material
to farmers for commercial
production
Encourage farmers to capture
rainwater by investing in
infrastructure (water tanks)
• Demonstrate benefits of existing
investments
Support ongoing activity to
establish local markets for farmers
to sell produce
Support school garden activities
(long term)

55
 There are existing policies on NCD, agriculture, health and nutrition, food security policies
which all have linkages to PROFAV. However, it is necessary to:
- improve links between production and food security and nutrition; and
- establish a work plan to implement existing policies.

Coordination among stakeholders

Barriers: Competing priorities, political interference
Regional coordination: SPC, UNICEF, WHO, FAO
• Sharing/dissemination of information among country representatives
• Facilitate technical assistance at a regional level

Communication:
• Email network preferred over website. Potential to use FAO PROFAV website to provide
relevant material from workshop.
• A one-pager brief to disseminate. Content: PROFAV purpose and benefits
• Good time to contact other relevant ministries so they can include PROFAV in their business
plans

Awareness raising:
• Linkage with world food day and in Fiji Food and Water day, world health day
• Financial incentives to encourage younger population to engage in ag in Fiji

Responsibilities of national teams:

• Goal setting
• Developing indicators for project outcomes
• Incorporate PROFAV into business plans
• Raising Awareness
• Monitoring and evaluation

56
Annex 2

Participants
Participants
No. Name Organisation Country
1 Dr Alisair Gracie University of Tasmania Australia
2 Dr Graham Lyons A.C.I.A.R & University of Adelaide Australia
3 Ms Karen Tairer Ministry of Health Cook Islands
4 Mr William Wigmore Director of Research Cook Islands
Ministry of Agriculture
5 Ms Ateca Kama Ministry of Health Fiji
National Food & Nutrition Center
6 Mr Halavatau Siosiua Deputy Director Fiji
Land Resource
SPC
7 Mr Ropate Ligairi Permanent Secretary Fiji
Ministry of Agriculture
8 Mr Shalendra Prasad Principal Research Officer (Horticulture) Fiji
Ministry of Agriculture
9 Ms Alison Hodder FAO, Senior Horticulture Officer Italy
10 Ms Makiko Taguchi FAO, Agricultural Officer Italy
11 Mr Minwook Kim FAO, Agricultural Officer Italy
12 Ms Rutiana Karebwa Agricultural Officer Kiriabti
13 Ms Carlinda Jabjulan Diabetes Coordinator Marshall Islands
Ministry of Health
14 Mr Karness Kusto Asst. Chief of Agriculture Quarantine Livestock Marshall Islands
Ministry of Resources & Development
15 Ms Theresia Y Kijiner Curriculum Specialists Marshall Islands
Ministry of Education
16 Mr Dean Phil Nevalagi Ministry of Education Niue
17 Ms Rose J Sionhane Charge Nurse Niue
Ministry of Health
18 Ms Eleutildu C Vainikolo Ministry of Agriculture & Food, Forests & Fisheries Tonga
19 Mr Aasa Tealofi Senior Agricultural Officer Tuvalu
Ministry of Natural Resources
20 Ms Pauke P Maani Ministry of Health Tuvalu
Nutrition & Dietectic PHU
21 Mr Sosea Tusialofa Education Officer Tuvalu
Government of Tuvalu
22 Mr Liu Pueata Tanielu Principal Crops Development Officer Samoa
23 Mr Sinei Fili Principal Officer Samoa
Ministry of Health
24 Mr Peter Sousa Hoejskov WHO, Technical Officer, Food Safety and NCD Switzerland
25 Ms Nellie Muru Ministry of Public Health Vanuatu
26 Dr Malapa Roger VARTC Vanuatu
27 Mr Massing Fernand Agriculture Officer Vanuatu
Agriculture Department

57
© CHALLIYIL ESWARAMANGALATH VIPIN

58
Rambutans
Annex 3

Workshop agenda

Monday, 20 October
08:00 Registration
09:00 Opening Ceremony
- Mr. Ropate Ligairi, Permanent Secretary, Agriculture, Fiji
- Mr. Peter Hoejskov, Technical Officer, WHO
- Ms. Alison Hodder, Senior Officer, FAO
- Mr. Siosiua Halavatau, Deputy Director (Food and Nutrition Security Program), SPC
10:00 Introduction of participants
10:30 Group photo and health break
11:00 Promoting Health through Horticulture Alison Hodder, FAO
11:15 Importance of Fruit and Vegetables for Public Health and food Peter Hoejskov, WHO
safety
11:45 ACIAR nutritious leafy vegetables activity in the Pacific Graham Lyons, ACIAR
12:00 The increasing mismatch between consumer-demand, health, and Alistair Gracie, Univ. of
supply of fruit and vegetables in Tasmania Tasmania
12:15 Lunch
14:00 Keynote – Improving the nutritional status of the population in Fiji Ateca Kama, Min. of
Health, Fiji
14:30 Presentation of STEPS methodology for surveillance of major Peter Hoejskov, WHO
health risk factors or other key topic suggested
14:50 PROFAV survey analysis and introduction of detailed survey Minwook Kim, FAO
15:10 Discussion
15:45 Health break
16:15 Keynote - Increasing production of fruits and vegetables in the Siosiua Halavatau, SPC
Pacific Islands - Challenges and Strategies
16:45 Invited case study presentations
17:15 Discussion
17:30 Introduction of working group sessions Facilitation Team
- Formation of working groups
- Working group objectives, themes, methods and expected results
18:00 Close for the day

59
 Tuesday, 21 October
09:00 Opening for the day and recap of yesterday
Working group sessions
09:30 Session 1 : Policy and strategy environment (health Facilitation Team
break at 10:30) 1: Alison Hodder, Siosiua Halavatau
2: Makiko Taguchi, Peter Hoejskov
3: Minwook Kim,Alistair Gracie
13:00 Lunch
14:00 Session 2 : Charting the challenge of increased F&V supply and consumption
15:30 Health break
16:00 Session 3 : Elements of a framework for action
17:30 Close for the day

Wednesday, 22 October
09:00 Session 4 : Promoting coordinated action (health break at 10:30)
13:00 Lunch
14:00 Session 5 : Outcomes of the workshop
- Review and conclusions in groups
16:00 Health break
Plenary
16:00 Session 6 : Working group reports and discussions Moderator: Alison Hodder
18:30 Close for the day

Thursday, 23 October
10:00 Draft report review and adoption of the workshop Facilitation Team
conclusions
12:30 Closing ceremony
13:00 Lunch

60
Annex 4

Questionnaire Instructions

Assessment of Fruit and Vegetable

Production and Consumption in the Pacific Region

INSTRUCTIONS AND DESCRIPTIONS

• Overview
The questionnaire contains the following sections:
Section 1: Production and trade
Section 2: Consumption of fruit and vegetables in the country
Responses to Part I (Production and Trade) should be just by participants in Ministries,
institutions or organizations related to horticulture production and Part II (Consumption) just
by participants in Ministries, institutions or organizations related to Health/Nutrition.

• Questionnaire completion
- On the coverage page, please provide the relevant information on National reporting
office, reporting or responsible officer, contact name, etc.
- Data should refer to national and annual coverage. For the purpose of data reporting,
kindly provide calendar year figures i.e. January to December. In the case of crops where
the harvest extends into the subsequent year, production should be allocated to the
calendar year in which the bulk of the harvest takes place.
- If your data has to be guessed, please clearly mark it in ‘information sources’.
- Please provide production in metric tonnes (MT) for each selected agricultural commodity.
- Please note that other instructions are included in the questionnaire for some specific
questions.
- Description of commodities are given in the section below.
- Official and estimated data currently available at FAOSTAT has been included in Annex
2. Please revise data if necessary and highlight any revision.
Official data previously reported have been included in this questionnaire. Please revise data if
necessary and highlight any revision.
Please refer to FAOSTAT data in Annex II (Production) and III(Trade).
- Please note that all data has a symbol, as below.
(blank) = official data
M  = missing data, or no data
* = data from non-official sources
F = estimated data
T = trend data
P= Trading Partners data
61
 You can find the name of the persons and the institutions to which the Annual Production
Questionnaire is sent in the following table.

Country Last Name First Name Institution

Cook Islands Tangimetua Taggy Statistics Office
Fiji Bainimarama Timoci Bureau of Statistics
Ministry of Finance and Economic
Kiribati Tiroa Tekena Development
Marshall Islands      
Nauru Gadabu Ipia National Statistics Office
Niue Vaha Kimray Statistics Niue
Palau Oilouch Dennis Office of Planning and Statistics
Papua New
Guinea Aka Joseph National Statistical Office (NSO)
Samoa Muagututi’a Sefuiva Reupena Samoa Bureau of Statistics
Solomon Islands Kimi Douglas Ministry of Finance and Treasury
Timor-Leste Ferreira Elias dos Santos Ministry of Finance
Tonga Finau Ata’ata Statistics Department Tonga
Tokelau      
Tuvalu Malona Semu Central Statistics Division
Vanuatu Johnson Simil Vanuatu National Statistics Office

DESCRIPTIONS
• Production
- Fruit
Production data of fruit crops relates to fruits actually harvested. Banana relates to that used as
“Fruit/dessert” while all others are included in “Plantains”. Data on Bananas and Plantains
relates to the weight of single Bananas and Plantains, excluding, therefore the weight of the
central stalk of the bunches. Nuts, Olives, Coconuts, Melons and Watermelons are not
included as fruit crops. “Fruit, nes” includes all other fruits not elsewhere specified (n.e.s) in
this group.
When you specify fruit, please refer to FAO’s 36 primary fruit crops:
1.Bananas, 2.Plantains, 3.Dates, 4.Figs, 5.Pineapples, 6.Avocados, 7.Mangoes (incl. mangosteen
& guavas), 8.Fruit,tropical fresh nes, 9.Oranges, 10.Tangerines,mandarins,clementines,satsu
mas, 11. Grapefruits and pomelos, 12. Lemons and limes, 13. Citrus fruit, nes, 14. Grapes,
15. Papayas, 16. Apples, 17. Pears, 18. Quinces, 19. Apricots, 20. Sour Cherries, 21. Cherries,
22. Peaches and nectarines, 23. Plums, 24. Strawberries, 25. Raspberries (incl. blackberries,
mulberries & loganberries), 26. Blueberries, 27. Cranberries, 28. Berries nes, 29. Currants,
30. Gooseberries, 31. Kiwi fruit, 32. Persimmons, 33. Pome fruits fresh, nes, 34. Stone fruits
fresh, nes, 35. Cashewapple, 36. Other fruits fresh, nes
The code and name of each is listed in the link below along with its botanical name, or names,
and a short description where necessary.
http://www.fao.org/economic/ess/ess-standards/comm-items/en/?chapter=8

62
 - Vegetables
Production data should cover only those vegetables which are cultivated exclusively for human
food. Crops cultivated both as field crops and garden crops in the open or under glass should be
reported together. Certain gramineous and leguminous plants are classified among Cereals and
Pulses if they are harvested for the dry grain. Vegetables that are harvested green for the green
grains and/or for the green pods (green maize, green peas, green beans, string beans, etc.)
should be included in this group. Production data for these commodities should include the
weight of the pods even though they are not eaten. Vegetables grown principally for animal feed
should be excluded from this group and should be included under Fodder Crops. Cabbages
include Brussels Sprouts, Green Kale and Sprouting Broccoli. Cauliflowers include
Heading Broccoli. The Vegetables group includes Melons and Watermelon. “Vegetables,
nes” includes all other vegetables not elsewhere specified (n.e.s) in this group.
When you specify vegetables, please refer to FAO’s 27 primary vegetable products:
1. Tomatoes, 2. Onions + shallots green, 3. Onions,dry, 4. Garlic, 5. Carrots, 6. Leeks and other
alliaceous vegetables, 7. Cauliflowers, 8. Cabbages, 9. Lettuce, 10. Cucumbers, gherkins, 11. Peas,
green, 12. Beans, green, 13. String beans, 14. Broad beans,green, 15. Artichokes, 16. Asparagus,
17. Eggplants, 18. Mushrooms, 19. Chillies and peppers(green), 20. Spinach, 21. Pumpkins,
squash, gourds, 22. Green Corn (Maize), 23. Okra, 24. Cassava leaves, 25. Watermelons,
26. Cantaloupes & other melons, 27. Vegetables fresh, nes
The code and name of each is listed in the link below along with its botanical name, or names,
and a short description where necessary.
http://www.fao.org/economic/ess/ess-standards/comm-items/en/?chapter=7

63
 Star fruit Carambola

64
© REX PE
Annex 5

Questionnaire

Assessment of Fruit and Vegetable Production and

Consumption in the Pacific Region

Introduction
The purpose of this survey is to collect available information regarding the horticulture value
chain, fruit and vegetable consumption and the importance of fruit and vegetables in local
diets. This information will be analyzed and presented at the workshop, and should serve as
background and a baseline for planning and formulating interventions in support of a national
initiative to promote fruit and vegetables for health at individual country level. It is planned
that programme managers and/or policy-makers of the sectors of Horticulture, Public Health/
Nutrition and Education, representing English-speaking countries of the Pacific Region, will
participate in the workshop (total three participants per country). This questionnaire should be
completed jointly by state actors from representatives of the agriculture, nutrition/health and
education sectors, if possible. We request that it be filled out and returned to us by 20 June
2014, at the latest.
A. Identification
[Please specify your name, which country you will represent at the PROFAV workshop,
and the name of the people who took part in this assessment:]
1. Country: 2. Name of Institution/ Organization:

3. Information supplied by : 4. E-mail :

5. People involved in this assessment :

Name Institution E-mail
i.

ii.

iii.

65
 B. National PROFAV platform
- A national PROFAV platform is composed by representatives from key ministries, including
agriculture, health/nutrition and education as well as other related ministries, including also
representatives of the private sector and NGO’s as appropriate.

1. Does your country have platform for promoting fruit and vegetable production,
supply and consumption?
- Yes or no? (Answer: )
- If yes, which areas’ representatives are involving in the coordinating team? Choose all
involving sectors and specify the contact point of representatives in the box of bottom.
1. agriculture/horticulture sector
2. nutrition sector
3. public health sector
4. education sector
5. financial sector
6. private sector
7. farmer’s unions, smallholders’ associations (representing producers)
8. consumers’ associations
9. academic sector(especially for programme design and monitoring)
10. local community leaders
11. women’s groups
12. other
- If no, please specify contact points of related public entities dealing with horticulture,
nutriition and education in the box of bottom.

66
C. Identification of national goals and objectives, and general barriers
C.1. Does your country have national goals and objectives to promote fruit and
vegetable production, supply, and consumption?
- If yes, please specify

• Overall goal :

• Health goal :

• Nutrition goals :

• Production goals :

• Distribution goals :

- Are these goals distinguished between short-, medium- and long-term objectives? If
distinguished, please specify?

67
 C.2. Please, rank five general barriers to fruit and vegetable promotion among
examples and describe them in detail:

(1)

(2)

(3)

(4)

(5)

<Examples>
• climate – seasonality, water availability, extremes of heat and cold, drought, rain;
• lack of horticultural technology and knowledge of management practices;
• competing government priorities(e.g. policies promoting cereal production on arable
land or with available irrigation water);
• economic issues – price, income, affordability at a local and individual level;
• attitudes of producers;
• cultural influences on consumers – traditional diets and cooking practices (can
be both barrier and facilitating factor), cultural misperceptions affecting dietary
preferences(e.g. fruit causes diarrhoea);
• taste and habit formation of diet patterns in childhood;
• lack of awareness/knowledge of benefits of fruit and vegetables, of preparation of
fruit and vegetables, of what constitutes a balanced diet as income increases (role of
increasing meat/fat consumption), also misperception of advertised health claims
of other products (functional foods);
• unhygienic practices in production and preparation of food;
• perception or communication of food-safety risks – chemical or micro biological
contamination;
• misinterpretation or distortion of information by the mass media;
• introduction or rapid increase of fast-food culture; ready-to-eat fruit and vegetables
are not easily available, but ready-to-eat fast food is easily available;
• competition for funding with other promotion programmes, and with more popular
foods;
• social acceptability of fruit and vegetable promotion interventions;
• lack of availability, inadequate marketing facilities;
• negative experiences with overproduction necessitating strategies for diversification,
better scheduling, value chain efficiency enhancement, and/or production shifts;
• others

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D. Activities at national level: Does your country have activities at national level?
D.1. Description of consumer domains
In order to design effective interventions to improve fruit and vegetable intake, it is essential
that the under-consuming population groups are identified and efforts made to understand
their consumption behaviours.
All consumer domains differ widely within and between countries. The characteristics outlined
below are not meant to be exhaustive, but to provide examples which may guide characterization
of consumer and supplier domains in specific countries and areas.
1. For rural smallholders producing fruit and vegetables for own consumption and
market supply
- own production of fruit and vegetables;
- collection of fruit and vegetables;
- exchange of fruit and vegetables for other goods, including gifts;
- often task division between and women; men produce cash crops, women produce
fruit and vegetables for won consumption around the house or in a small garden;
- vegetables consumed are more often home-grown; fruits, if consumed, more often
purchased.

2. For Mixed consumers – rural and particularly urban gardeners, but also dependant
on market supply
- occasional fruit and vegetable producers, but their major income is non-agricultural;
- often belonging to low- to mid-income levels;
- may have limited knowledge of the nutritional value of fruits and vegetables and/or
a cultural bias against certain fruit and vegetables;
- commonly purchase fruit and vegetables from local market or small shops;
- fruit and vegetables which they grow are limited in range and amount.

3. For Market-dependent consumers

- dependent on cash economy, most of them living in urban or peri-urban areas thus
they have a limited ability to grow food;
- many women in this group work outside the home; hence there is less time available
for food preparation and a greater need for convenience and processed food;
- part of food consumption is outside the home, less cooking takes place in the
household;
- poor consumers in this group often purchase in small amounts because of lack of
cash; hence are not able to benefit from supermarkets offering bulk purchases to
reduce costs, resulting in higher food costs;
many do not have access to conditional transfers (transfers of resources to poor
families on condition that they engage in some behaviour, e.g. sending children to
school, taking children to health clinics), social safety nets or food aid programmes.

4. Institutional consumers
- Schools, worksites, hospitals and care facilities, military, prisons, feeding programmes

69
 D.2. Activities for rural smallholders producing fruit and vegetables for own
consumption and market supply
D.2.1. Please rank specific barriers in examples to fruit and vegetable promotion for
rural smallholders and describe your national situation in detail

(1)

(2)

(3)

(4)

(5)

<Examples>
∗ extreme poverty of producers and consumers
∗ low-quality varieties of crops (no crops improvement)
∗ non-availability of seeds/planting material
∗ human resource and labour constraints
∗ lack of basic enabling knowledge
∗ others, if any

D.2.2. Choose all activities which should be taken up by your country and mark “x”
in the brackets
a. Increase and diversify fruit and vegetable production to achieve year-round
diversity, safety and quality

( ) Safety and quality to increase intake

( ) safe fruit and vegetable programme
( ) GAP – focus on pesticide use and prevention of contamination

( ) Cultivar improvement, selection and promotion: targeting nutrient content,

quality, flavour:
( ) promote crops/varieties with high nutrient levels

( ) Promoting techniques to extend production season;

( ) phasing production
( ) water

b. Increase availability and affordability of fruit and vegetables: Build capacity

for:

( ) Technologies for post-harvest loss reduction

( ) harvesting technology
70
 ( ) processing technologies
( ) better storage
( ) packaging for freshness
( ) reducing domestic level losses through education of women

( ) Scheduling and managing production to reduce seasonal gaps and gluts to

safeguard producer and consumer price convenience

( ) Creating new networks to facilitate transport, haulage and marketing

( ) Increasing small grower involvement and benefit sharing through:

( ) promoting small farmer entrepreneurship
( ) promoting schemes for transparent price information and fair practices
by intermediaries
( ) disseminating market information e.g. boards with prices in rural areas
( ) direct marketing (promotion of farmers’ markets)

c. Change knowledge, attitudes, behaviour

( ) Education programmes – for women, children, farmers, development agents,

extensionists, policy makers and planners, managers, subject-matter specialists
( ) Access to existing information and knowledge – ensure use of proper media
( ) Behaviour change – facilitated participatory planning
( ) Social marketing – produce marketing boards, where active, to support groups,
programmes, networks

d. Increase amount of fruit and vegetables consumed, replacing energy-dense,

nutrition-poor foods, where needed

( ) Use local media (especially radio), competitions, role play, theatre, market-
place exhibitions
( ) Educate mothers about a healthy diet at child-weighing or vaccination clinics;
promote fruit and vegetable consumption instead of nutrient-poor foods
D.3. Activities for mixed consumers – rural and particularly urban gardeners, but
also dependent on market supply

D.3.1. Please rank specific barriers in examples to fruit and vegetable promotion for
mixed consumers and describe your national situation in detail

(1)

(2)

(3)

(4)

71
 <Examples>

∗ insufficient land and/or lack of urban/peri-urban land-use policies for horticulture

∗ low income
∗ lack of appropriate technology
∗ inadequate supplies of clean water and thus food contamination risks
∗ others, if any

D.3.2. Choose all activities which should be taken up by your country and mark “x”
in the brackets
a. Increase and diversify fruit and vegetable production to achieve year-round
diversity, safety and quality

( ) Collect, collate and disseminate information on successful gardening

programmes
( ) Foster gardening networks, communities, clubs, etc.
( ) Make land available for gardening in urban and peri-urban areas
( ) Organize training and extension programmes on gardening, nutrition, food
safety, etc.
( ) Rescue traditional varieties/indigenous fruit and vegetables

b. Increase availability and affordability of fruit and vegetables

( ) Improve marketing infrastructures

( ) Promote income-generating programmes

c. Change knowledge, attitudes, behaviour

( ) Organize media campaigns

( ) Review school curriculum and other national policies and strategies to support
gardening and educated about health benefits of fruit and vegetables

d. Increase amount of fruit and vegetables consumed, replacing energy-dense,

nutrition-poor foods, where needed

( ) Develop and promote simple small-scale food preservation methods at

household level
( ) Promote recipes using fruits and vegetables

D.4. Activities for market-dependent consumers

D.4.1. Please rank specific barriers in examples to fruit and vegetable promotion for
market-dependent consumers and describe your national situation in detail

(1)

(2)

72
<Examples>

∗ high price of fruit and vegetables in retail outlets;

∗ change in employment and lifestyle with urbanization; lack of time for preparation
and cooking as urbanization increases and more women work outside the home.
∗ Others, if any

D.4.2. Choose all activities in your country and mark ‘x’ in brackets
a. Increase and diversify fruit and vegetable production to achieve year-round
diversity, safety and quality

( ) Work with peri-urban small-scale producers to identify types of fruit and

vegetables that are appropriate for these types of projects;

( ) Supply-chain improvement projects addressing efficiency from seed/field

through market to table with appropriate technological innovation and
information systems; need to take account of food safety issues (use of safe
water supply);

( ) Agricultural training in whole range of techniques and issues about efficient

and safe production; from production to preparation for sale. This should
include education and training.

b. Increase availability and affordability of fruit and vegetables

( ) Small scale production/home production, food preparation and selling (for

income generation);
( ) Alternatives for commercialization – promote approaches to complement
distribution through supermarket chain;
( ) Specific policies to support local supply.

c. Change knowledge, attitudes, behaviour

( ) Education targeting women and men about:

( ) good nutrition and how to achieve this in the diet
( ) fruit and vegetables as part of balanced diet
( ) importance of fruit and vegetables for tacking micronutrient
deficiencies in children
( ) prevention of CVD, obesity, cancer etc.
( ) safe preparation and culturally-appropriate cooking and storage
techniques
( ) Mass media education campaigns to inform about the benefits of fruit and
vegetables for tackling over-nutrition, NCDs and micronutrient deficiencies

d. Increase amount of fruit and vegetables consumed, replacing energy-dense,

nutrition-poor foods, where needed

( ) Public education campaigns to promote increased utilization of fruit and

vegetables in restaurants (education regarding health benefits and how to
increase fruit and vegetable sales)

73
 D.5. Activities for institutional consumers: Schools, worksites, hospitals and care
facilities, military, prisons, feeding programmes

D.5.1. Please rank specific barriers in examples to fruit and vegetable promotion for
institutional consumers and describe your national situation in detail

(1)

(2)

<Examples>

∗ acceptability and feasibility of promotional programmes

∗ interests of the institutional food provider competing with fruit and vegetable
promotion
∗ others, if any

D.5.2. Choose all activities which should be taken up by your country and mark “x”
in the brackets

a. Increase and diversify fruit and vegetable production to achieve year-round

diversity, safety and quality

( ) Linked to institutional feeding programmes organized by the government e.g.

for hospitals, camps, armies, schools, correctional facilities, provide seeds and
training to help local communities produce fruit and vegetables for feeding
programmes

( ) Supply-chain-based horticultural development projects to encourage farmers

and peri-urban growers in suitable areas to grow fruit and vegetables and
benefit from value chains linked to institutional feeding programmes

b. Increase availability and affordability of fruit and vegetables

( ) School-linked gardens
( ) encourage the use of indigenous fruits and vegetables; teach both boys
and girls how to cook
( ) get parents and other adult members of wider school community
involved

c. Change knowledge, attitudes, behaviour

( ) Engage public figures to promote increasing intake of fruit and vegetables

( ) Link healthy diet with physical activities/sports
( ) Give recognition to NGOs and religious leaders working towards promoting
better nutrition
( ) Education regarding cooking and preparation of fruit and vegetables for food
workers in communities, schools, restaurants
( ) Retain or (re)insert nutrition and cooking as part of the school curriculum

74
 ( ) School gardens – education regarding gardening and balanced nutrition
( ) Field trips to local markets or supermarkets to educate school children about
fruit and vegetable availability
( ) Providing fruit snacks in schools and worksites

d. Increase amount of fruit and vegetables consumed, replacing energy-dense,

nutrition-poor foods, where needed

( ) School food programmes (at school and national levels; whether free,
subsidized or paid meals) tailored so that they increase fruit and vegetable
consumption by schoolchildren (i.e. as part of balanced diet, not just about
under-nutrition), connected with supply-side interventions to promote/
support local production

( ) Government food programmes to be consistent with national nutrition

policies and promote purchase and consumption of fruit and vegetables

E. Does your country have a “Horticulture Development Strategic Plan”

a. No

b. If ‘yes’, please provide the reference and indicate whether its refers to the
promotion of the consumption of fruits and vegetables

F. Does the country have a Food Composition Table (FCT) giving the nutrient
values for Fruit, Vegetables and other food items?
a. If ‘no’, what FCT are you using? (e.g. of any International Organization, any
other country, etc)

75
 b. If ‘yes’, please provide the name of the FCT and contents.

Are there any recent or ongoing studies on the nutrient values of Fruit and
Vegetables?

a. No

b. If ‘yes’, please provide the complete references of the reports and studies:

G. Does the country have Food-based Dietary Guidelines?

a. No

b. If ‘yes’, please provide the name and contents of the Guidelines and if it is
online, please provide link:

76
H. National Programme for the Promotion of Fruit and Vegetable Consumption

1. Is there, or has there been, a campaign to promote the consumption of Fruit and
Vegetables, or is one planned?
a. No

b. If ‘yes’, please specify:

2. In your opinion, what would be the main target groups of population concerned
by a national programme for the promotion of fruit and vegetable consumption
(e.g. school children, mothers, youth, urban or rural households, HIV/AIDs-affected, other)

Please indicate the three priority target groups:

Group 1:

Group 2:

Group 3:

3. For each of these priority target groups, please specify an overall goal and up to
three specific results which could be linked with interventions or activities:

For example, an overall goal might be something like ‘ increase fruit and vegetable consumption’,
whilst specific goals might be related to specific target groups, e.g. for Urban population in
slum areas a specific result might be to increase the consumption level to 1 ( two servings per day)

77
 List overall goals by group and up to three specific expected results for each over a period of
3 years:
Target Overall goal Specific results

1.
2.
Group 1:
3.
1.
Group 2: 2.
3.
1.
Group 3: 2.
3.

I. Ideas for the fine-tuning of the agenda of the workshop

1. In your opinion, what could be the most efficient intervention pathway(s) for
involving each of the target groups suggested in Section D above?

Group 1:
Suggested intervention pathway(s):

Group 2:
Suggested intervention pathway(s):

Group 3:
Suggested intervention pathway(s):

78
2. In your opinion, which stakeholders (from the public and private sector as well
as NGOs and civil society) should be involved in the implementation of this kind
of programme for the promotion of fruit and vegetable consumption? As far as
possible, specify their role(s) and their potential action pathway(s).

For queries about this questionnaire, please contact: Minwook.Kim@fao.org

THANK YOU FOR YOUR COLLABORATION!

79
References

Bourke, R.M. & Harwood, T., eds. 2009. Food and Agriculture in Papua New Guinea. ANUE
Press, The Australian National University, Canberra.
FAO. 1992. World Declaration on Nutrition. 1992 International Conference on Nutrition. Rome.
(Available at ftp://ftp.fao.org/es/esn/nutrition/ICN/icndec.htm)
FAO. 1996. World Food Summit. Rome. (Available at http://www.fao.org/wfs/index_en.htm)
FAO. 2002. Report of the World Food Summit: Five years later. Rome. (Available at http://
www.fao.org/docrep/MEETING/005/Y7106E/Y7106E00.htm)
FAO. 2004. Fruit and vegetables for health: Report of a Joint FAO/WHO Workshop, Kobe, Japan.
Rome.
FAO. 2006. Agriculture 21Magazine, 0606: 2.
Mercer, P. 2007. South Pacific is ‘fattest region’ (available at: http://news.bbc.co.uk/2/hi/
health/6396111.stm).
Secretariat of the Pacific Community. 2010. NCD Statistics for the Pacific Islands Countries and
Territories. Suva, Fiji.
Tasmanian Government. 2013. State of Public Health. Population Health, Department of Health
and Human Services. Hobart.
United Nations. 2014. The Millenium Development Goals Report 2014. New York, USA.
UNCTAD. 2012. The least developed countries report 2012: Harnessing Remittances and Diaspora
Knowledge to Build Productive Capacities. New York & Geneva, UN.
WHO. 2010. Pacific islanders pay heavy price for abandoning traditional diet. Bulletin of the
World Health Organization, 88(7): 484-485.
WHO. 2011. Papua New Guinea country profile 2011. Papua New Guinea.
WHO. 2013. Country Cooperation Strategy at a glance: Pacific Island Countries (available at
http://apps.who.int/iris/handle/10665/136831).

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